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Which is Better: Buvidal or Methadone for Addiction?

September 28, 2025

6:41 am

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A man sits on a messy bed, clutching his stomach in pain.

Table of contents

Introduction

There are more urban myths and legends about Methadone than there are about the deaths of Princess Diana, Bruce Lee and JFK: Combined.

Misinformation is dangerous as it distracts from the benefit hundreds of thousands of people have received from treatment with Methadone. It works: Fast.

Known by different names in different countries (and different colours: Green in the UK, Orange in the US) Methadone will rid you of withdrawals and can be used as a maintenance tool or for detox.

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Gold standard

The Department of Health guidelines on drug dependency, known as the Orange guidelines, clearly state that Methadone is the gold standard of treatment.

As with any field of medicine, there are advances in treatment but that is not to say that legend treatments are not effective.

Buvidal is a new drug but is also an old drug. It is an injectable form of the drug Buprenorphine.

There are also myths around Buprenorphine/Buvidal which sometimes steer people towards it when a more cautious approach would be useful.

Buvidal Vs Methadone. Sounds like a Rocky film. There are some key differences between them. Let me explain…..

Opioid substitution Therapy (OST)

Opioid Substitution Treatment (OST) is the mainstay of treatment for heroin/opioid addiction across the world. There are two very commonly used medications that are used Methadone and Buvidal

Both medications have been in use for many, many decades* and there is a plethora of evidence based research to demonstrate how effective they are.

Available for free from local authority services

Every local authority drug and alcohol service offers these , if appropriate to your needs and they are also available at nearly every private centre/outpatient service.

(*Buvidal is a more modern way of taking Buprenorphine through injections rather than tablets.)

Due to the way services are commissioned and funded your GP can not prescribe Methadone or Buvidal for addiction.

Both medications are used for pain management, but usually through a specialist service.

Here at Find Me a Rehab we have experienced addictions clinicians who have many decades experience prescribing both methadone and buprenorphine. If you, a loved one, friend, relative or employee need a Free Rehab Referral Service call us. We provide Free Clinician Drug Advice.

It is often thought that Methadone and Buvidal are very different: Not so! Let’s take a closer look:

Clinicians Prescribe Them for the Same Reasons

The aim of Opioid Substitution Therapy (OST) is to prevent someone wishing to get free of opioids from going through withdrawals and cravings.

Due to the way opioids work on chemical pathways in the brain, when you stop using them, channels in the brain are affected with leads to physical symptoms, as well as psychological effects.

Opioid withdrawal symptoms

Should someone stop using opioids without substitution therapy, the following may be experienced:

  • Severe insomnia
  • Extreme agitation and anxiety
  • Excessive yawning
  • Very heavy sweating
  • Persistent loose stools
  • Painful stomach cramps
  • Goosebumps
  • Heavy flu like symptoms

Never try and treat yourself at home

If someone goes into withdrawal it can be very distressing: It can also be very dangerous.

Forget what you see on TV and in films that people can “ride it out” going “cold turkey” (reference to goosebumps).

Self treatment can be fatal

Severe withdrawals can be fatal due to dehydration from loose stools. When someone is in withdrawal they have incredibly strong urges to use so as to stop the symptoms of withdrawal.

The problem is that your tolerance to opioids will drop: Quickly.

When someone is in severe withdrawal they will try and reverse the effects by using a larger amount of opioids than they are used to using.

Combine this with a drop in tolerance and the risks significantly increase.

Methadone and Buvidal will both stop these withdrawals.

They are both opioids though they work slightly differently.

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Key Takeaways

  • Methadone is the gold standard for opioid substitution therapy, while Buvidal is a newer injectable form of Buprenorphine.
  • Both medications effectively prevent withdrawal symptoms, but they attach to opioid receptors differently: Methadone is a full agonist, and Buvidal is a partial agonist.
  • Clinicians prescribe Methadone and Buvidal for the same reasons to manage opioid addiction and reduce withdrawal symptoms.
  • Methodologically, Methadone has more extensive research backing its use since the 1940s, while Buvidal has only been available for the last decade.
  • Pregnant women can use Methadone and Buvidal, but switching medications during pregnancy poses risks due to withdrawal symptoms.

How to initiate OST

Methadone can be started as soon as someone starts to withdraw whereas Buvidal needs to be started when you are in withdrawal.

This is because Buvidal will “knock off” opioids on receptors in the brain and thus push you into withdrawal.

Here at Find Me a Rehab we have experienced addictions clinicians who have many decades experience prescribing both methadone and buvidal.

If you, a loved one, friend, relative or employee need a Free Rehab Referral Service call us. We provide Free Clinician Drug Advice.

They’re Both Opioids

Both methadone and Buvidal are opioids. Methadone is fully synthetic whereas Buvidal contains some natural compounds.

Buvidal attaches itself to some of the opioid pathway receptors whereas Methadone attaches itself to all of them. In technical terms, Methadone is a full agonist whereas Buvidal is a partial agonist.

They Have Similar Side Effects

As both Methadone and Buvidal are both opioids they can cause side effects which are very similar:

  • Constipation
  • sweating
  • Sleeplessness
  • Feeling dizzy
  • Lightheadedness
  • Vomiting
  • Nausea

While these side effects can be mildly uncomfortable, they usually subside and your clinician will always be happy to discuss. There are medications that can be taken to reduce these.

You Can Use Them as Maintenance Medications

The most effective way to use Methadone and Buvidal is to, first, get stabilised on them and then stay on that dose for a year before reducing.

Clearly, that does not suit everyone but for those who choose this treatment pathway, there is a high chance of abstinence from opioid use.

This is known as maintenance and is a very effective treatment.

However, this doesn’t suit everyone and the majority of people who use OST look for a detox over a periods of weeks: rather than months.

What are the key differences between Methadone and Buvidal?

Methadone has been in use since the 1940s so there is more research available.

Originally, it was designed as a low cost pain killer. In the 1960’s heroin addiction became more prevalent and it was found that Methadone was an effective way of preventing continued use.

To this day, it is considered the gold standard of opioid substitution treatment.

Buprenorphine was not licenced in the US until 2002 in tablet form.

Injectable Buprenorphine (Buvidal) has only become available in the last decade.

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Buprenorphine is a “blocker”

This is partially correct.

Methadone covers all the opioid receptors in the brain.

The more you take: The more the effect it has.

With Buvidal , the medication does not produce the same intense effects.

Once a certain amount is taken, taking more will have little effect.

This doesn’t mean, however that you cannot overdose if you took copious quantities.

As such it is considered safer for those with a moderate opioid habit but less useful for those who are using very large amounts of heroin/opioids.

Taking Buprenorphine on holiday/business trips

Methadone is a liquid.

While it is sometimes possible to get a prescription for Methadone tablets when travelling overseas, these are extremely difficult for pharmacies to source and stock.

You can take Methadone on a plane but with Buvidal, once you have had your injection, there is nothing else to do!

There is a monthly version so it can be possible to be away for 28 days. As it takes days to ware off after 28 days you don’t have to have another one bang on day 29.

Which works better: Methadone or Buvidal?

Both Methadone and Buvidal can be very effective.

One thing to note is the percentage of people who complete treatment using either medication. A 2014 study in America found that far more people commit to a treatment plan using Methadone than those who use Buprenorphine.

However, scientifically, both are equally as effective. The study found that:

  • A quarter of those using Buprenorphine stopped treatment within a month. Only 8% of Methadone patients stopped within the same period.
  • Over seven in ten patients completed a treatment programme with Methadone where as it was only four in seven with Buprenorphine
  • Half of those using Buprenorphine quit treatment within six months.

Buvidal Vs Methadone: Key Differences

Buvidal vs. Methadone in Pregnancy

Pregnant women are not allowed to participate in drug trials for obvious reasons.

Thus, the effects of medications on the fetus is not studied when medications are developed.

What is known is that stopping opioids while pregnant can be dangerous to the unborn child.

The uterus can contract leading to a spontaneous abortion (miscarriage) as well as premature birth.

Methadone has, for decades, been used by pregnant women.

To date there is no evidence that Methadone causes birth defects.

Some babies may experience withdrawals when born but this is easily treated.

Breastfeeding

Methadone can be used when breastfeeding.

While there is a small amount of methadone in breastmilk, it will not affect the baby.

Buprenorphine can also be used by pregnant women.

The only caveat being that it is recommended not to switch from Methadone to Buprenorphine while pregnant.

This is because you have to be in withdrawal before stating Buprenorphine which puts the woman at risk of craving and using opioids.

The Role of Methadone and Buvidal in OST

Every research paper on the subject always demonstrates how these medications can provide a lifeline to abstinence when combined with therapy.

They are not standalone treatments.

Simply drinking Methadone or dissolving Buprenorphine is not going to cure your addiction.

Using OST in rehab

Residential rehab, combined with OST is the most effective road to meaningful recovery.

Addiction is a symptom of underlying trauma. If you engage in therapy, while having OST and combine this with relapse prevention skills training and aftercare, you stand a very strong chance of sustained recovery.

Use our experience

Here at Find Me a Rehab we have experienced addictions clinicians who have many decades experience prescribing both methadone and buprenorphine.

If you, a loved one, friend, relative or employee need a Free Rehab Referral Service call us. We provide Free Clinician Drug Advice.

Get help

You can email, call or live chat with an experienced addictions clinician on any aspect of opioid addiction, Methadone, Buprenorphine , Buvidal, detox, rehab, home treatment, relapse prevention and aftercare.

They can advise on treatment plans, treatment options, locations, costings and logistics.

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