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Methadone vs. Buprenorphine

Methadone and Buprenorphine are both-long acting opioids used in opiate addiction treatment. They are both administered in the context of a Medically Assisted Treatment (MAT) plan in which regular dosages are gradually reduced under the supervision of a physician. The long-acting nature of these drugs make them an effective choice to combat addition. Rather than delivering a short-acting, highly concentrated dose like heroin, methadone and buprenorphine are used to reduce or eliminate the symptoms of opioid withdrawal.

There are differences in how these two medicines affect the body and in how they are selected as appropriate for individual patients. In this post, we seek to explain the main differences between the drugs and the conditions that make MAT a suitable approach for treating opiate addiction.

Partial Vs. Full Agonist

Methadone is a full opioid agonist—as the dosage level increases, it continues to affect opioid receptors until all receptors are activated or the maximum effect is attained. This makes it suited for patients who are dependent on high dosages of opiates.

Buprenorphine, in contrast, is a partial opioid agonist. There is a ceiling effect no matter the dosage of buprenorphine, in that its effects on opioid receptors taper off at a certain level of exposure, even were the dosage to be increased.


Many physicians use buprenorphine and methadone interchangeably in their MATs. There are situations where one medicine may be more suitable for a given patient than another.

Given its ceiling effect, buprenorphine can combat addiction in patients with a lower dependence on opiates. Methadone is usually indicated when a patient presents with a long history of addiction or is dependent on higher doses. In some cases, patients are switched to buprenorphine following a period of progress and improvement through methadone treatment.

In general, while both drugs are effective in the context of an MAT program, buprenorphine represents a lower-dosage solution in less severe cases of addiction.


In an MAT program, patients visit a facility where their regular dosage of methadone or buprenorphine is administered by a physician. When methadone is used, this regimen remains the same throughout the course of treatment.

Buprenorphine is approved at the federal level for self-administration by patients. With a doctor’s approval, patients can take their supply of medication home, self-administer based on physician instructions, and make their visits to a clinic to fulfill the additional requirements of their MAT regiment like regular office visits and drug screening.

While the federal government has taken a position on buprenorphine, not all states have approved it for self-administration. Your doctor can advise you on the treatment options available to you.

For a free and confidential consultation about addiction recovery, contact BornFree Wellness Center here or at 240-654-4001.

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