A Comparison of Suboxone and Methadone in the Treatment of Opiate Addiction

A comparison of suboxone and methadone in the treatment of opiate addiction

The rate of opiate addiction and dependence is growing exponentially in the United States. Since 1990, the rate of drug overdoses have more than tripled and the majority of these are caused by opiates. Opiates are a class of medication defined as a psychoactive substance that is derived naturally or synthetically but has similar effects to morphine. This includes medications such as codeine, oxycodone, heroin, and even methadone and buprenorphine. Opiates are legally prescribed to patients for pain management of acute, chronic, or surgical pain. Patients taking these medications long term often develop a tolerance, or need for increased dosages to achieve analgesia. This can further develop into an opiate dependence, in which the patient requires continued dosages to prevent withdrawal symptoms. However, some people also develop an addiction to opiates, which is defined as the inappropriate use of medication for purposes other than those it was prescribed for and despite medical, legal, and social consequences. Addiction is frequently associated with psychological attributes while dependence and tolerance are more physiological, but addiction and dependence are often coexistent. Addiction and dependence can occur in any person and is regularly the result of taking more than the prescribed opiate dose or obtaining opiates illegally so the user can experience desired effects such as analgesia or euphoria. As a result of the analgesia and euphoric effects, there is a high addiction potential for many individuals, which is why opiate addiction and dependence is such a widespread problem.

The growing incidence of opiate addiction and dependence necessitates that effective treatment is developed to treat addiction and prevent overdose. Currently, treatment for opiate addiction is a difficult, complicated, and a multifocal process. Addiction is a complicated disease and has many physical and psychological components that need to be addressed in order for treatment to be effective. Addressing the psychological components of addiction are key in long term success of treatment, but helping the patient end their dependence on the opiate and preventing them from restarting use of the drug is very difficult. Today, medication is being used by many treatment programs to help patients manage their addiction with the hope that they can one day achieve opiate abstinence. Methadone has been used for this purpose for decades and more recently a combination drug of buprenorphine and naloxone (Suboxone) was introduced. These medications share many similarities but differ greatly in side effects, cost, and other areas. This literature review will examine both medications and compare and contrast their use in the treatment of opiate addiction.