Suboxone vs Methadone as Treatment for Opioid Abuse

Christine Hughes

Tusculum College

December 9, 2012

Opioid drugs like oxycodone, hydrocodone, and meperidine are categorized in a group of the most powerful pain killers. These drugs are used to treat severe acute pain for a relatively short period of time such as following a surgery as well as various types of chronic pain lasting longer than 3 months. There is no argument that these drugs are needed and useful to humans. The argument is whether or not these drugs should be prescribed for things such as headaches, oral surgery, arthritis etc. Opioids target the same brain receptors as the illegal synthetic opiate called heroin. The rate of prescriptions has increased ten times what it was twenty years ago because of the fact that it is prescribed for too many different reasons and for long term use. These drugs are highly addictive and easily tolerated by most people.
The problem is that opioids will cause a sense of euphoria much like heroin which is highly attractive to drug abusers. Columbia University researchers reported that opioid addiction had tripled over a ten year period and in 2009 the National Survey on Drug Use and Health reported that nearly two million Americans were abusing or dependent upon prescription pain medication like those mentioned above. These rates are two times as great as the number of people addicted to cocaine (“Painkillers fuel growth in drug addiction,” 2011). Addiction to these pain killers is not specified to any particular population. Anyone who is exposed to these drugs even for a fairly short period of time can easily become dependent on them. Painkillers fuel groth in drug addiction, 2011, reports that 4% of all opiates obtained for non-medical reasons were from internet vendors, 5% from drug dealers, 18% from a prescribing physician and 70% of these medications are obtained from friends and family. This makes the teenage population also susceptible to abuse. Many children take what they can find in their parents medicine cabinet. There is an alarming rate reported in the age range of 12 to 25 year olds that have become addicted to opiates. Opiates create long term changes in the brain and crippling withdrawal symptoms which often lead to cravings and relapse. Treatments range from inpatient treatment to detoxification cold turkey. People do not normally die from withdrawal but many report feeling like they are dying. This is why there is a huge incidence of redosing to prevent withdrawal symptoms. There are two drugs that clinicians use to help with this withdrawal process and/or treatment. Methadone and buprenorphine can be used during both detoxification and maintenance therapy. Some people have to take these aids for the rest of their lives in order to stop or deter the cravings and relapse. Methadone has been available as an approved narcotic painkiller for more than fifty years. It is currently available as a liquid, tablet, or dispersible tablet called a diskette. The Food and Drug Administration (FDA) approved the dispersible tablet for the treatment of addiction but not for pain management. The 5 and 10 mg strength tablets are approved by the FDA for pain management. However, other formulations, including dispersible tablets have been prescribed for pain management. Methadone is safe when used properly. It has been used to save many lives of those addicted to opiates. Any physician prescribing methadone needs to fully understand that it is powerful with potentially serious side effects. Methadone is a long-acting medication with a long half-life. The half-life does vary from person to person and ranges between 8 and 59 hours. Levels can remain in the liver and fatty tissue as is slowly released back into the bloodstream. This causes prolonged duration of methadone’s actions despite low levels in a person’s blood and urine. Methadone can then cause toxic levels if a person who