Methadone and Buprenorphine: Another Addiction?

Patient Receiving Methadone
Methadone Use Is Highly Monitored. © Getty Images

Question: Is the Use of Methadone and Buprenorphine Replacing One Addiction for Another?

Answer: No, as it pertains to medical treatment for heroin addiction. According to the National Institute on Drug Abuse, methadone and buprenorphine are safe and effective medications for opiate addition when used as directed.

Both drugs are administered under monitored, controlled conditions. The effects they have on the patient are very different from those of heroin.

They are not a heroin substitute.

Regardless of how heroin is taken - injected, snorted or smoked - it quickly produces a brief period of euphoria, known as a "rush," that also very quickly wears off. As the effect begins to wear off, the user experiences a "crash."

Typically, users who are crashing experience intense craving for more heroin to create another rush and stop the crash. This cycle of rushing, crashing and craving - if repeated serval times a day - is a sure sign of addiction.

This cycle is caused because heroin almost immediately affects the user's brain but only last for a very short duration. If the cycle is repeated several times a day, it can disrupt important bodily functions and severely disrupt the user's behavior.

In comparison to heroin, methadone and buprenorphine have much more gradual onset, so patients do not experience any rush. Both medications wear off far more slowly than heroin, so they do not produce a sudden crash.

Both methadone and buprenorphine significantly reduce the user's desire for heroin.

According to NIDA research, anyone who is on a regular maintenance schedule of methadone and buprenorphine and tries to take heroin will find the euphoric effects of heroin greatly reduced. Also, patients treated with these drugs will not suffer the medical abnormalities and behavioral disruptions that heroin addicts experience.


National Institute on Drug Abuse. "Frequently Asked Questions." Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Updated December 2012

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