For years, state governments have been treating heroin addicts with Methadone. As a drug that uses the same receptors in our brains that heroin would use and has some of the same effects (without the same level of euphoria), it can eliminate painful heroin withdrawal symptoms.
Because it blocks the “high” of any heroin ingested while it is present, Methadone can reduce a user’s desire to take heroin. Methadone maintenance programs are big business in the U.S., run by for-profit corporations and supplied by leading pharmaceutical companies.
Is Methadone as Addictive as Heroin?
Although methadone programs claim that heroin users will eventually be able to also stop taking Methadone, this has not been the experience of the majority of patients. In fact, many addiction professionals consider Methadone to be just as addictive as heroin, meaning those on Methadone maintenance programs simply switch from being addicted to heroin to being addicted to Methadone. Because Methadone still produces a “high”, users will try to abuse it on order to get the same effect as heroin. It is considered to be a “full agonist”. This is great for the companies that run Methadone clinics, but this is a serious drug subject to overdose and abuse and cannot be prescribed in a doctor’s office.
Structured drug addiction treatment, without the use of a heroin substitute, is usually the only way to get a person completely clean. Unfortunately, these Methadone programs are allowed to persist because people on Methadone are less likely to commit crimes (why would they when the drug is being given to them) and take up costly jail space, transmit disease, or perpetuate the stigma of illicit drug use. This is great for government and elected officials and costs relatively little compared to the costs of incarceration, bad press, or formalized addiction treatment programs.
The Lowdown on Suboxone
Enter Suboxone. Suboxone, introduced in 2002, is a combination of buprenorphine and naloxone that comes in tablet form and is used to treat opioid addiction. It is only a “partial agonist.” Suboxone acts in much the same way as Methadone, blocking the opioid receptors so that heroin can’t get there, but produces even less of a high.
More importantly, it does not depress respiration like Methadone and introduces a “ceiling,” over which the positive feeling associated with taking the drug does not increase. In fact, when Suboxone is crushed and snorted or injected, it will actually cause immediate withdrawal symptoms including cramping, vomiting, and muscle aches. This means Suboxone has a lower risk of overdose, side effects, addiction, and abuse.
Methadone is typically injected intravenously and requires the presence of a medical professional for each dose. Because Suboxone is able to be prescribed by a doctor and taken at home, it is vastly cheaper to administer than Methadone, which requires structured programs, monitoring, and counseling.
Why is Methadone Still Favored Over Suboxone?
Suboxone is quickly becoming the favored alternative to heroin addiction and formalized drug treatment programs. Governments, on the other hand, are slower to catch on.
Although most doctors have the ability to prescribe dangerous opioids, such as OxyContin, that lead to addiction, very few have been approved to prescribe Suboxone.
Most government funded insurance programs still favor Methadone treatment over Suboxone prescriptions.
The cynic in me feels that this is likely a direct result of lobbying by Methadone clinic owners to prevent their bread and butter product from falling out of favor. Time will tell.