Vivitrol vs Suboxone: Comparing Medications for Opioid Use Disorder

Vivitrol vs Suboxone: Comparing Medications for Opioid Use Disorder

Understanding Opioid Use Disorder (OUD)

Opioid Use Disorder (OUD) is a chronic brain disease that leads to the compulsive use of opioid drugs, including both prescription opioids and illicit opioids. This condition is often linked with physical dependence, cravings for opioids, and a high risk of relapse. Opioid addiction treatment includes various FDA-approved medications and behavioral therapy. Two of the most effective options for managing opioid dependence are Vivitrol and Suboxone.

How Vivitrol Works

Vivitrol is a long-acting form of extended-release naltrexone, a prescription medication approved by the U.S. Food and Drug Administration for the treatment of opioid use disorder and alcohol dependence.

Opioid Antagonist Mechanism

Vivitrol is an opioid antagonist, meaning it blocks opioid receptors without activating them. This action prevents the euphoric effects and pain relief typically caused by addictive opioids, reducing the risk of relapse and opioid misuse. The effects of Vivitrol include a reduction in drug cravings and a lower risk of overdose.

Monthly Injectable Administration

Vivitrol is administered as a once-monthly injection or intramuscular shot, making it a convenient option for people who want to avoid the commitment of daily tablets or oral medication. Many patients refer to them as Vivitrol shots. The injectable form is often used under medical supervision as part of a comprehensive addiction treatment program.

Use in Alcohol Use Disorder Management

Vivitrol is also approved for the treatment of alcohol dependence. It reduces cravings for alcohol, making it an excellent option for people with both alcohol use disorder and opioid addiction.

How Suboxone Works

Suboxone treatment is another effective medication for managing opioid addiction. It is made from a combination of buprenorphine and naloxone.

Partial Opioid Agonist Mechanism

Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors but with limited intensity. This helps manage opioid withdrawal symptoms and drug cravings without causing intense feelings of euphoria. Naloxone, the second active ingredient, helps reduce the potential for misuse by blocking the effects of injected Suboxone.

Sublingual Administration

Suboxone is available in sublingual tablets, Suboxone pills, and dissolvable films. It is taken daily under the tongue and delivers a steady dose of medication. Suboxone prescriptions are often part of opioid treatment programs and medication management strategies.

Ceiling Effect to Reduce Abuse Potential

Because buprenorphine has a ceiling effect, increasing the dose of Suboxone beyond a certain point does not enhance its effects. This limits its abuse potential and supports long-term recovery. The effects of Suboxone include reduced cravings and milder withdrawal symptoms.

Comparing Side Effects

Vivitrol Side Effects

Common side effects of Vivitrol include injection site reactions, joint pain, abdominal pain, stomach pain, fatigue, and blurred vision. Rare but serious adverse side effects include liver damage and irregular heartbeat. Since Vivitrol lowers opioid tolerance, there’s an increased risk of overdose if someone relapses.

Suboxone Side Effects

Suboxone patients may experience constipation, sweating, insomnia, and headaches. In some cases, long-term use can lead to dental problems and hormonal imbalances. Suboxone has potential short-term side effects and a risk of dependency, especially with high Suboxone doses.

Efficacy in Treatment

Managing Withdrawal Symptoms and Cravings

Suboxone is ideal during the opioid detox phase because it relieves severe withdrawal symptoms. It is often used early in the recovery journey. Vivitrol requires full opioid detoxification before the first dose to avoid severe withdrawal. Once detoxed, Vivitrol becomes an effective option for maintaining sobriety.

Impact on Abstinent Days

Both medications increase abstinent days. Suboxone improves success rates during early stages of recovery, while Vivitrol performs well in later phases of the recovery process.

Risks of Physical Dependence

Vivitrol does not cause physical dependence. Suboxone, as a form of buprenorphine, can lead to some level of dependence, requiring a tapering plan under a qualified provider.

Cost Considerations

Price Differences

Vivitrol is often more expensive, costing hundreds of dollars per dose for each month injection. Suboxone, available in generic forms, may be more affordable for daily use.

Insurance Coverage and Support

Both medications are covered by many insurance plans. Treatment providers often help patients with prior authorization and insurance coverage questions. Some manufacturers offer patient assistance programs.

Safety Profiles

Risks and Precautions with Vivitrol

• Must be opioid-free for 7–14 days
• Increased risk of overdose if opioids are used after treatment begins
• Can cause liver-related potential long-term side effects
• Requires injection of naltrexone under supervision

Risks and Precautions with Suboxone

• Risk of opioid misuse if taken outside of prescription
• Should not be mixed with benzodiazepines or alcohol
• May require regular weekly therapy sessions or attendance at therapy

Potential for Abuse

Suboxone has some potential for diversion and risk of misuse, particularly when injected. Vivitrol has no addiction potential or potential for abuse.

Flexibility in Switching Treatments

Who Might Benefit More from Vivitrol?

• People who have completed a detox program
• Those with alcohol addiction and opioid addiction
• Patients with a history of opioid abuse or opioid overdose
• Individuals looking for a maintenance option with once-monthly intramuscular injection

Who Might Benefit More from Suboxone?

• Individuals still in early recovery
• Those experiencing opioid withdrawal symptoms
• People needing flexibility in dose prescribed
• Patients who benefit from daily visits and a daily pill form

Conclusion and Decision-Making Factors

Both Vivitrol and Suboxone are effective treatments for opioid addiction. Each has its strengths. Suboxone is more helpful in the early phase of treatment when managing withdrawal is critical. Vivitrol supports individuals in later stages of the recovery journey, helping prevent opioid relapse without the use of opioid agonists.

At Opus Treatment, our qualified staff and addiction specialists help build personalized treatment plans using the best treatment options for each patient. We combine FDA-approved medications, behavioral therapy, and mental health services to support complete recovery.

If you’re considering Vivitrol vs Suboxone, reach out to our treatment centers to speak with a healthcare provider about what’s best for your situation. Let us help guide your path to a happier future.