At the Morse Clinics, methadone is dispensed by our nurses in the form of a cherry- avored, red liquid that is swallowed every morning. Because we use the liquid, we can dose down to the exact milligram. There is no limit to the dose of methadone, but we do check blood levels at 120 mg and every 30 mg thereafter to insure safety. Buprenorphine is dosed in 2 mg or 8 mg tablets – dosing options are limited to 1, 2, 4, 8, 12 or 16 mg taken sublingually and absorbed within about 5 minutes. An advantage of buprenorphine is that you do not need a gut to absorb the medication. If you have the u or a GI bug that causes you to vomit, you cannot vomit up your buprenorphine. However, you can vomit up methadone. For our patients who have extensive GI surgeries, gastric bypasses, IBS, or Crohn’s Disease, buprenorphine may be more effective. It is not unusual for folks to get addicted to opioids due to pain conditions. Methadone is usually more effective treating pain than buprenorphine. To get started, if you are actively using, methadone is easier on you. Buprenorphine can cause precipitated withdrawal. Buprenorphine displaces full opioid agonists (because of its higher receptor af nity and lower level of receptor activation). The severity of withdrawal varies. Common features include sweating, cramps, diarrhea, nausea, anxiety, cravings, yawning, and restlessness – typical opioid withdrawal symptoms that you are probably accustomed to experiencing. Precipitated withdrawal usually occurs about 30 minutes after the rst dose and peaks at 90-180 minutes after the rst dose. Minor symptoms may last 2-3 days and may persist with continued heroin/opioid use. “Methadone is usually more effective treating pain than buprenorphine.” -Dr. Eric Morse, founder, Morse Clinics
“MANY OF OUR PATIENTS CHOOSE TO REMAIN ON THEIR MAINTENANCE MEDICATION INDEFINITELY.” -Dr. Eric Morse
COST AND COMING OFF If you have Medicaid, your treatment at any Morse Clinic is free for methadone. It may be free for buprenorphine as well – if your MCO is Sandhills or Cardinal Innovations. If you do not have Medicaid, the cost of methadone is $80 per week and Buprenorphine is $120 per week – regardless of the dose. The difference in cost makes some of our patients choose methadone over buprenorphine. Which is easier to come off of? First of all, we recommend at least a year clean, sober and stable (same job, living situation, relationship) before starting a gradual taper down. Many of our patients choose to remain on their maintenance medication inde nitely. Addiction is a chronic disease and most chronic diseases require chronic medications. Because you can lower 1 mg a time of the methadone liquid, a methadone taper can be easier and more gradual. Because buprenorphine is only a partial agonist, an abrupt detoxi cation off buprenorphine is easier than methadone. So if there is a possibility that you may be going to jail or prison, I would suggest buprenorphine over methadone. Please come into a Morse Clinic and talk to one of our doctors for more information.
Thanks, Eric D. Morse, M.D.
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