Suboxone and Vivitrol are two medications that can help people overcome opioid addiction. They are used as a part of a comprehensive approach to addiction treatment called medication-assisted treatment (MAT), which combines medications with counseling and behavioral therapy.

While both medications have the same end goal–to promote recovery–each one works differently. Suboxone can ease withdrawal symptoms and reduce cravings, while Vivitrol is used after detox to reduce the risk of relapse.

Suboxone vs. Vivitrol

What is Suboxone?

Suboxone is a brand-name medication that was approved by the U.S. Food and Drug Administration (FDA) in 2002 for the treatment of opioid dependence and addiction. It comes in the form of a sublingual film or tablet that is taken daily.

Suboxone contains two active ingredients: buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Buprenorphine binds to the brain’s opioid receptors and partially activates them. Although it acts on the same receptors in the brain as other opioids, it does not produce the same high that addictive opioids like heroin or oxycodone do. Instead, it reduces opioid withdrawal symptoms and cravings for opioid drugs.

Naloxone, however, is added to Suboxone to prevent misuse of the medication. When taken as directed (under the tongue), the naloxone remains inactive. But if someone were to try and inject Suboxone, the naloxone would activate and knock all opioids off of opioid receptors, reversing the effects of opioids in the body. This sudden displacement of opioid molecules can result in the appearance of moderate to severe withdrawal symptoms.

People who participate in Suboxone treatment may begin taking the medication 12-24 hours after their last dose of opioids. It has been shown that, by reducing withdrawal symptoms, Suboxone can eliminate the need for inpatient detoxification and improve retention in treatment.

What is Vivitrol?

Vivitrol is a brand-name medication for an extended-release formulation of naltrexone. It was approved by the FDA initially in 2006 for the treatment of alcohol dependence, but in 2010 it was also approved to treat opioid use disorder.

Vivitrol is a monthly injection that is given intramuscularly, usually in the buttocks/gluteal muscle. Individuals must detox completely before starting Vivitrol and abstain from alcohol and/or opioids for at least 7-14 days before starting it.

Given every 28-30 days, Vivitrol provides the body with a steady dose of naltrexone which can reduce cravings for opioids and alcohol. With fewer cravings, individuals are less likely to relapse.

Naltrexone works by binding and blocking opioid receptors. When used to treat alcohol use disorder, this mechanism of action is thought to help stabilize brain chemistry and reduce the desire to drink. For opioid addiction treatment, naltrexone occupies opioid receptors which can alleviate cravings for opioid drugs.

Side Effects of Suboxone vs Vivitrol

Suboxone and Vivitrol may cause different side effects. With Vivitrol, the most widely reported side effects are injection site reactions, such as pain, redness, swelling, irritation, and/or itching at the injection site.

Being an oral medication, Suboxone does not cause injection site reactions. It can, however, cause poor taste in the mouth as well as pain, redness, and tingling in the mouth or on the tongue. This occurs because the medication is taken as a sublingual film or tablet rather than an injection.

Other common side effects of Vivitrol include:

  • Headache
  • Dizziness
  • Reduced appetite
  • Insomnia
  • Toothache
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Joint pain or stiffness
  • Muscle cramps
  • Weakness or fatigue

Common side effects of Suboxone include:

  • Nausea
  • Vomiting
  • Headache
  • Sweating
  • Numbness in the mouth
  • Constipation
  • Painful tongue
  • Dizziness
  • Fainting
  • Difficulty concentrating
  • Irregular heartbeat
  • Insomnia
  • Blurry vision
  • Back pain
  • Drowsiness

Since Suboxone is a partial opioid agonist, it can also cause respiratory depression in high doses. Treatment centers that prescribe Suboxone or Vivitrol closely monitor patients for any side effects and practice medication management which can improve medication compliance.

Highlighting Key Differences Between Suboxone and Vivitrol

Both Suboxone and Vivitrol are powerful tools that can restore lives damaged by addiction. However, there are many important differences between the two medications.

Active Ingredients

One of the main differences between Suboxone and Vivitrol is their active ingredients. Suboxone is a combination medication that contains buprenorphine and naloxone, while Vivitrol only contains naltrexone.

Designated Use

Suboxone is only FDA-approved to treat opioid use disorder, but Vivitrol can help people who are addicted to opioids as well as those who are addicted to alcohol.

Treatment Initiation

Individuals can begin taking Suboxone 12-24 hours after their last dose of opioids. It can help ease withdrawal symptoms during detox. Vivitrol, on the other hand, is given 7-14 days after the last dose of opioids or drink of alcohol. Unlike Suboxone, Vivitrol is not used during detox.

Method and Frequency of Administration

Suboxone is an oral medication that is taken every day by mouth. By contrast, Vivitrol is a deep intramuscular injection that is given once a month.

Potential for Physical Dependence

Suboxone contains buprenorphine which can be physically habit-forming. As a result, the abrupt cessation of Suboxone can result in withdrawal symptoms. Individuals typically have to taper off Suboxone slowly to avoid withdrawal.

Naltrexone, on the other hand, is not habit-forming, so people do not experience withdrawal when they stop taking Vivitrol.

Abuse Potential

Both medications are safe and effective when taken as directed, but Suboxone has a slightly higher abuse potential. Some people may try to abuse Suboxone to get high on buprenorphine. However, it has a ceiling effect, meaning the buprenorphine stops producing effects at a certain dose.

While people can take Suboxone prescriptions home with them, the same cannot be said for Vivitrol. Vivitrol is only administered in a physician’s office and it cannot get people high. As a result, there is virtually no risk of abuse or addiction.

Find Out if Medication-Assisted Treatment (MAT) is Right for You

As a comprehensive approach that includes counseling, behavioral therapy, and medications, MAT is a highly effective care method that can help you get sober. If you or a loved one are interested in learning more about MAT or finding out if this approach is right for you, please contact our team at First Step Behavioral Health today for a confidential, risk-free assessment.

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