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Suboxone and Methadone: Opioid Treatment Debate

In one of my recent blog posts, The Best Way to Quit Using Drugs, I discussed various means in which an individual could try to arrest his/her addiction. In response to the article, I had two readers comment with opposing points of view. One raised the point that treatments like Suboxone (Buprenorphine) and Methadone have been used to help treat addiction to opioids. The other reader had a more abstinence-based response and stated that one needs to address his/her addiction by kicking the habit “cold turkey.”

Facts About Opiate Addiction

So let’s take a closer look at opiate addiction. Here are some facts about this disease:

  • According to the 2005 National Survey on Drug Use and Health almost 2 million Americans are opioid dependent (read Opioids: Addiction to Prescription Painkillers)
  • Approximately 4.7 million teenagers and adults used opioid prescription painkillers for nonmedical purposes
  • Approximately 32.7 million Americans report having used opioid prescription painkillers for nonmedical purposes at least once in their lives.

Opium History

The opium poppy was first cultivated in lower Mesopotamia in 3400 B.C. In 1841, the Chinese were defeated by the British in the First Opium War. Importing opium became legal in 1856 after a second Opium War. Heroin, an opiate synthesized from morphine, makes its appearance in 1895 when The Bayer Company of Germany dilutes morphine with acetyls. The drug is introduced commercially three years later. In 1905, opium is banned by the U.S. Congress. And the rest is, as they say, history.

Methadone was created in 1939 as a painkiller in Germany. Suboxone, on the other hand, was first marketed in the 1980’s as a long-term replacement therapy for opioid dependence. Each of these substances have been viewed as being beneficial for the treatment of opioid withdrawal.

Ethical Considerations in Treating Opioid Addiction

As pointed out in the beginning of this post, there has been considerable debate over the efficacy of Suboxone and Methadone treatment as well as their abuse by addicts who obtain these substances by illegal means or through “doctor shopping.” As with other substances, Suboxone has the potential to be abused.

So the question is: Is treatment for opioid addiction via Suboxone and Methadone beneficial? In my personal opinion, I would have to say yes, however I do believe that many prescribers maintain their patients on this drug therapy too long. Anecdotally speaking, a new client to the program in which I work stated that she has been on Suboxone for 4 years. I do not see how this length of treatment can serve to benefit someone.

In the end, for the heroin/opiate addict who wants to be relieved of the horrors of withdrawal Suboxone and methadone can certainly be useful. But care must be taken not to create dependence to another substance. There are certain ethical factors that must be taken into consideration. Addiction is addiction. And there is a price that must be paid for by who still suffer.

APA Reference
Shallowhorn, K. (2013, March 25). Suboxone and Methadone: Opioid Treatment Debate, HealthyPlace. Retrieved on 2021, May 18 from https://www.healthyplace.com/blogs/debunkingaddiction/2013/03/suboxone-and-methadone-the-debate-continues-3



Author: Karl Shallowhorn, MS, CASAC

narek
February, 13 2015 at 2:20 pm

I know a lot of people in my life that have been or are addicted to some form of opiate drug. It's horrible in every case! My sister was put on Morphine for migraine headaches in 1996 and was told that she wouldn't get addicted because she was in pain.
Well, nothing could have been further from the truth. She had never done drugs or alcohol in her life and was a very devout L.D.S. (Mormon).
She lost everything, her job, her new car, that she wrecked, her kids and her home, her beauty and her brilliant mind and self respect!! She went through rehab, got right back on it, put back on Methadone, and finally she says she off the Methadone but has turned to hard liquor and is a horrible alcoholic.
She's homeless and violent. After 19 years, she is a shadow of her former self. I've seen other people addicted to heroin and oxycontin, lortab and percocet that are dead. Some dead from the methadone!!
Other's diagnosed with alzheimer's after an injury, that were put on opiates, from the rehab! Doctors in this country are now becoming drug dealers!!
This is a nightmare..It's happening to my mom right now. My biological dad has a form of alzheimer's after he was put on percocet after back surgery. My step-father died after he was put on a 3 drug coctail of Morphine, Ativan and Halidol given by the hospice when he had kidney cancer!
These unsuspecting lives have been ruined by these horrible drugs! Don't give another addicting drug to a drug addict!! That is wrong! Methadone and Suboxone are very similar and they are addicting and deadly also! I've watched this happen for over 40 years!! It needs to stop!!
Opiate drugs should ONLY be used for short term, extreme pain!! Otherwise, it causes more pain, not just physically but the mental anguish it causes is worse than pain or death in many many cases!!

zoekaitlyn
April, 15 2014 at 8:48 am

I work in a suboxone clinic and have found that most of the patients think that Suboxone is a miracle drug.

Emily
October, 24 2013 at 1:20 am

I was a nurse at a methadone clinic and have a family member who has been on methadone and suboxone, at different times. Both times, it is an immediate need to get their life back in order, as to why they go there. Both methadone and suboxone can help people get back to "normal" and function as human beings. They seem like miracle drugs in that sense. However, both are also highly addictive. So you are swapping one addiction for another- but it is 100X better than still using opiates/heroin. Personally, I am more for Suboxone. It's easier for a person to return to a normal schedule because they are only seen usually once a month. VERY expensive though- insurance usually covers it, thankfully. They definitely can help turn your life around though!

Johannes Holleritter
March, 26 2013 at 3:50 pm

My son died of acute narcotic toxicity one year ago. Since then, I have been researching the drug which he was on for nearly 3 years. I have taken everything I have learned about this drug and made it into a blog. It seems that everything you read about Suboxone is positive. If you do a google search on Suboxone or buprenorphine, you have to get past pages and pages of paid advertising and pro-Suboxone information to find any negative information about Suboxone at all. This is not fair to addicts who should be given all the information out there that is necessary to make an informed decision. What I have found out is scandalous. There are an increasing number of media accounts and studies concerning crime, overdoses, death, diversion and addiction problems associated with Suboxone (Buprenorphine). I present this information as a public service to those that are only told one side of the Suboxone story…
www.SuboxoneAbuse.Wordpress.com
Also, if you want to read about it from those that are addicted to Suboxone, go here:
www.Subsux.com .

Tim
March, 26 2013 at 12:49 pm

I agree with what Eliza says. I've been on suboxone for about 3 years, and lately I've started to reduce my dose with the intention of getting off it completely. When I first went on it I wasn't in any sort of place to be abstinent as my life was a bit of a wreck. Now I'm better prepared and have better coping skills, and have some distance between myself and my drug of choice. Without suboxone I really don't know what would have happened to me as my drug use was out of control. So I think it can be a good tool for recovery as it gives you the space to be able to get your life back together.

Eliza Player
March, 26 2013 at 5:18 am

I was on methadone maintenance for over three years before deciding to become opiate free. I would have never come to this decision without the help of methadone. For me, and many others who chose to go the methadone or suboxone route, I was not ready to be opiate free when I first decided I needed to change something. Methadone provided the bridge that I needed to get to the point where I thought I could live without opiates. The treatment planted the seeds for my eventual decision to become opiate free. But, I also do not think I would have reached that point if I had stayed on methadone for any less time. I was given coping skills while attending the methadone clinic, and I worked to improve so many other areas of my life- and that became the catalyst in my decision to eventually become opiate free. Many people who have worked with methadone and harm reduction would agree that the treatment should be used FOR AT LEAST two years before the patient decides to wean of the medication. It is tough for some to have their only method for coping (drug use) taken away before there are other methods in place. Methadone allowed me to put those other coping skills in place, and when I finally got off methadone- I never went back.
In my opinion, suboxone can be very good for simply detox, but for many people...it is needed for much longer. Taking something like suboxone or methadone allows the user to put their life back together, and gain those much needed coping skills in place, which can really be essential to not relapsing later. For a chronic relapser, longer term use of suboxone and methadone is actually recommended as the best treatment.
The long and short of it is that we are all different, and what worked for one may not work for another. While methadone worked wonders for me, it did not work for many others. While abstinence did not work for me, it also works wonders for many others. There is no wrong way to do the right thing, and if we have more options available, more people will find recovery. We need to have as many options available for treatment, in hopes that something works....

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