Vivitrol and Suboxone: Comparing Two Treatments for Addiction Recovery

Trying to choose between Vivitrol and Suboxone for opioid addiction treatment? This guide explains how each medication works, its differences, and what to consider when deciding between them.

Key Takeaways

• Vivitrol is an injectable opioid antagonist effective against both opioid and alcohol use disorders, while Suboxone is a daily oral medication that acts as a partial opioid agonist for opioid dependency.
• Suboxone is suitable for individuals experiencing withdrawal, as it can be initiated during those symptoms, whereas Vivitrol requires patients to be opioid-free for a period before administration.
• Choosing between Vivitrol and Suboxone should be based on individual circumstances, including medical history, medication adherence preferences, and the treatment goals established with healthcare professionals.

What is the difference between Vivitrol and Suboxone?

Vivitrol and Suboxone are two widely used medications in the fight against opioid addiction, each with unique mechanisms and treatment protocols. Vivitrol, an injectable form of naltrexone, works as an opioid antagonist. For a broader comparison, see our full guide on naltrexone vs Suboxone to prevent the euphoric effects of opioids. In contrast, Suboxone, a combination of buprenorphine and naloxone, functions as a partial opioid agonist, activating opioid receptors to alleviate withdrawal symptoms without producing a high.

Suboxone is typically taken daily in pill or film form, making it convenient for those who prefer a regular routine. Meanwhile, Vivitrol is administered as a monthly injection, which can be a more practical option for individuals who struggle with daily medication adherence. Vivitrol is also FDA-approved to treat alcohol use disorder, whereas Suboxone is used exclusively for opioid dependency.

Here is a brief comparison table to highlight the key differences:

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Knowing these differences can guide you and your healthcare provider in choosing the prescription medication that best suits your needs.

How does Suboxone work?

Suboxone is a combination of buprenorphine and naloxone, two components that play crucial roles in treating opioid addiction. Buprenorphine acts as a partial opioid agonist, which means it binds to opioid receptors in the brain but activates them only partially. This reduces withdrawal symptoms and cravings without producing the euphoric high associated with full opioid agonists.

Naloxone, the second component, is an opioid antagonist that is included to discourage misuse. If Suboxone is taken as prescribed, naloxone remains inactive. However, if someone attempts to inject the medication to get high, buprenorphine naloxone becomes active and can precipitate withdrawal symptoms, thereby serving as a deterrent.

Suboxone is usually given as sublingual tablets or films taken daily, integrating well into a broader Medication-Assisted Treatment (MAT) program.

How does Vivitrol work?

Vivitrol, known generically as extended-release naltrexone, operates as a full opioid antagonist. Unlike Suboxone, which partially activates opioid receptors, Vivitrol binds completely to these receptors, preventing any euphoric effects from opioids and reducing the risk of relapse. This makes it particularly effective for individuals who have fully detoxed from opioids and are committed to staying clean, especially when considering options like oral naltrexone.

The medication is administered as a monthly intramuscular injection, providing a consistent level of protection against opioid and alcohol cravings. Patients must be opioid-free for 7-14 days before starting Vivitrol to prevent severe withdrawal symptoms. This requirement can be a hurdle for some, but for those who manage to detox, Vivitrol offers a reliable long-term solution.

Vivitrol vs. Suboxone: Pros and cons

When comparing Vivitrol and Suboxone vs Suboxone, several factors come into play, each with its own set of advantages and drawbacks.

Effectiveness in Treating Opioid Use Disorder: Suboxone has demonstrated a higher success rate in preventing relapse, with 57% of patients relapsing compared to 65% for those on Vivitrol.

Craving Reduction: Suboxone provides an average of 10 opioid-free days, while Vivitrol offers around 4 during the study period.

Relapse Prevention: Vivitrol requires patients to be opioid-free for several days before administration, which can be a challenging prerequisite.

Risk of Misuse or Diversion: Both medications have similar rates of adverse events, including overdose risks, with no significant difference noted.

Convenience and Compliance: Suboxone allows for daily home use, making it more convenient for many patients. In contrast, Vivitrol’s monthly injection might be more suitable for those who struggle with daily medication adherence.

Side Effects and Safety Profile: The side effects of both medications are generally manageable, but each has its own profile that patients should consider.

The choice between Vivitrol and Suboxone generally hinges on personal circumstances, such as patient history, care access, and individual preference.

What are the side effects of Vivitrol and Suboxone?

Both Vivitrol and Suboxone come with their own sets of side effects, which patients should be aware of before starting treatment.

Suboxone Side Effects

Common side effects of Suboxone include:

• Nausea
• Headache
• Constipation
• Drowsiness

There is also a potential for Suboxone addiction, although this risk is generally lower compared to full opioid agonists and untreated opioid dependence.

Vivitrol Side Effects For those receiving Vivitrol, common side effects include injection site reactions, headaches, and fatigue. There’s also a risk of liver damage, so liver function needs to be monitored regularly. One of the most serious risks is the potential for overdose if a patient relapses after stopping Vivitrol, as their tolerance to opioids will be significantly reduced.

Healthcare providers must carefully monitor two medications to manage side effects and ensure safe use.

Who is a good candidate for Suboxone or Vivitrol?

Selecting the best candidate for Suboxone or Vivitrol involves factors like detox requirements, co-occurring disorders, substance use disorders, and medication adherence.

Suboxone is ideal for individuals with opioid use disorder who are still experiencing withdrawal symptoms, as it can be started during the early stages of withdrawal. It is also suitable for suboxone patients who may have difficulty adhering to a monthly injection schedule and prefer the convenience of a daily medication.

Vivitrol Candidates On the other hand, the Vivitrol shot is best suited for those who have completed a full detox and are looking for a long-term solution to prevent relapse. It’s also a good option for individuals who may struggle with daily medication adherence and prefer a once-monthly injection.

Considerations such as treatment access, support systems, and personal preferences should also play a role in the decision-making process.

How to choose between Vivitrol and Suboxone?

Choosing between Vivitrol and Suboxone is a decision that requires careful consideration of various factors. Consulting medical professionals and addiction specialists is essential for making an informed choice that aligns with personal health needs and lifestyle.

Practical Tips for Decision Making: Consider factors such as:

• Affordability and insurance coverage, noting that Vivitrol’s monthly injection can be more expensive compared to Suboxone, which has varying monthly costs.
• Practical aspects like the need for supervision.
• Lifestyle compatibility, for example, those who prefer a less frequent dosing schedule might opt for Vivitrol.

Consider Medical History and Current Health: Take into account personal medical history, previous addiction treatments, and any co-occurring disorders. Suboxone may be more accessible for individuals who need immediate intervention during withdrawal, while Vivitrol requires a period of opioid abstinence before starting.

Decision-Making Checklist: Create a checklist with the following factors to aid in decision-making:

• Treatment goals
• Detox requirements
• Cost
• Convenience
• Personal preferences

This comprehensive approach ensures that the chosen medication aligns with the individual’s overall recovery plan.

Can you switch from Suboxone to Vivitrol (or vice versa)?

Switching between Suboxone and Vivitrol is feasible but involves several critical steps and considerations. The clinical process of transitioning from one medication to another can be complex and should be supervised by a healthcare professional.

Clinical Process and Challenges Transitioning from Suboxone to Vivitrol requires patients to be fully detoxed from opioids. This means completing a detoxification period, which can be challenging but is necessary to avoid severe withdrawal symptoms. Conversely, switching from Vivitrol to Suboxone may be somewhat easier, as Suboxone can be started while the patient is still experiencing withdrawal symptoms.

Real-World Scenarios There are scenarios where switching might be medically necessary or preferred, such as experiencing severe side effects from one medication or finding that one medication better suits the patient’s lifestyle and adherence capabilities. Consult a healthcare provider to ensure a smooth and safe transition.

Vivitrol and Suboxone in long-term recovery programs

Vivitrol and Suboxone both play key roles in long-term recovery programs, often as part of a holistic treatment plan that includes therapy, counseling, and peer support.

Vivitrol suits individuals who have completed detoxification and seek a consistent, monthly treatment for long-term recovery in sober living. Its extended-release formulation aids in maintaining adherence and reducing cravings, making it a reliable option for sobriety.

Supporting Transition and Stability Suboxone benefits those still transitioning through the recovery process by:

• Alleviating withdrawal symptoms
• Reducing cravings, making it easier for patients to stabilize during the early stages of recovery
• Providing a daily dosing regimen that ensures regular medication adherence, crucial during the initial recovery phase.

Retention Rates and Relapse Prevention Studies show that both medications can reduce opioid use and prevent relapse, though their effectiveness may vary based on recovery stage and individual needs. Incorporating these medications to treat opioid use into a comprehensive treatment plan with behavioral therapy and support resources can significantly enhance recovery outcomes for individuals with illicit opioid use and opioid use disorders. Addressing opioid abuse is also crucial in the overall strategy for successful recovery.

Final thoughts: Finding the right medication for recovery

Choosing the right medication for addiction medicine recovery is a personalized decision best made with healthcare professionals. Both Suboxone and Vivitrol can effectively reduce cravings and prevent relapse, but the best choice depends on individual circumstances, such as the stage of recovery, medical history, and lifestyle preferences. Drug cravings can also influence this decision.

Medication-Assisted Treatment (MAT) should be seen as a step toward sustained sobriety, complemented by behavioral therapies and support systems. The journey to recovery is multifaceted, and finding the right medication and drugs is an integral part of a comprehensive addiction treatment plan.

FAQs about Vivitrol and Suboxone

Can you take Suboxone while pregnant?

Yes, Suboxone can be taken during pregnancy, but it is essential to do so under medical supervision to ensure the safety of both the mother and the baby.

Is Vivitrol effective for alcohol addiction?

Vivitrol is indeed effective for alcohol addiction, as it is FDA-approved to help reduce cravings and prevent relapse in individuals with alcohol use disorder.

How long should you stay on each medication?

The duration of each medication depends on individual needs and recovery progress; understanding how long you should be on Suboxone is key to setting realistic treatment expectations. Therefore, it is essential to consult with your healthcare provider for a tailored treatment plan.

Are there withdrawal symptoms after stopping Vivitrol?

There are no withdrawal symptoms associated with stopping Vivitrol; however, it is crucial to have a continued support plan in place.

Can you switch from Suboxone to Vivitrol (or vice versa)?

Yes, switching between Suboxone and Vivitrol is possible, but it must be done under the careful management and supervision of a healthcare professional to ensure a safe transition.

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