It’s always a question whether methadone or buprenorphine might be the right medication for any patient. When talking about methadone we’re really talking about a whole sort of treatment structure or program. Essentially with methadone treatment, there’s built in counseling, which is very important as part of the recovery process. There’s urine drug testing which you might think, ‘well, why would I want urine drug testing?’ Many people actually find it a real support in working on their recovery. There’s also more services available in a methadone program.
In regards to buprenorphine, treatment happens largely in integrated medical settings. So it might happen with your primary care doctor, it might happen with your psychiatrist. It’s very convenient and you also have the simplicity of receiving a prescription for your medication and going to the pharmacy.
If you have a chronic pain problem where you’re needing to take opiate pain medications, then generally speaking buprenorphine is less of a good choice for you because it is very strong in terms of blocking the affects of opiates and it can be difficult to do a good job of treating pain with opiates on top of it. Methadone is going to make you have less problems with pain management, so that’s a big consideration also.
Also keep in mind that if a choice is made to treat with buprenorphine and for whatever reason that that’s not working well, you can make a switch and try treatment with methadone. One can go the other way as well. If you’re in methadone treatment and it’s decided at a certain point to switch to buprenorphine treatment, then that’s possible also.