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Suboxone vs. Vivitrol: Which Is Better?

There are safe, effective medications to help people kick opioid addiction to the curb. We offer two of these medications: Suboxone (buprenorphine) and Vivitrol (naltrexone extended release as a shot). Which is better? That depends on your own needs in opioid addiction recovery.

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Medications like Suboxone and Vivitrol are proven to treat opioid addiction. So which is the right choice for you?

The opioid epidemic continues to make headlines across the country. The good news: there is safe, effective medication to help people kick opioid addiction to the curb. Here at Workit Health, we offer two of these medications: Suboxone (buprenorphine) and naltrexone (brand name Vivitrol when administered as an extended-release shot). Which is better? That depends on your own needs in opioid addiction recovery. We break down the basics.

What is Suboxone?

Buprenorphine is an opioid medication used to treat opioid addiction. It can be administered by sublingual (taken under the tongue) films (Suboxone), sublingual tablets (Zubsolv) or as a once-a-month, extended-release injection (Sublocade).

Wait a minute, you may be thinking, an opioid to treat addiction? All opioids stimulate the body’s opioid receptors, but unlike heroin or pain pills, buprenorphine only partially stimulates opioid receptors. That means that the maximum opioid effects of buprenorphine like euphoria happen less than with other opioids. This “ceiling effect” is why medications containing buprenorphine can reduce symptoms of opioid withdrawal and reduce cravings for opioids, with less potential for misuse than heroin or pain pills.

Benefits of Suboxone

  • If you’ve gone through opiate withdrawal, you know that it sucks. Suboxone reduces withdrawal symptoms and improves your mood as you get off of heroin or pain pills.
  • Suboxone will reduce your cravings, which can further help you focus on recovery.
  • Your provider can prescribe you Suboxone at any point in your recovery process. At Workit, most of our members can see their providers entirely online.

Trade-offs with Suboxone

  • Because it is an opioid, buprenorphine can be misused. The naloxone in Suboxone and Zubsolv help prevent misuse. When taken properly, the naloxone does not get absorbed by the body. But if the meds are dissolved and injected or smoked, the naloxone will cause sudden withdrawal.
  • Only providers with a waiver to prescribe buprenorphine can treat you with this medication. You can find Suboxone doctors in your area at Health offers Suboxone treatment in several states.

 What is the right treatment for you? Suboxone and Vivitrol both have pros and cons.

What is the right treatment for you? Suboxone and Vivitrol both have pros and cons.

What is Vivitrol?

While buprenorphine partially stimulates opioid receptors, naltrexone, the active ingredient in Vivitrol, blocks those receptors. Vivitrol is a once-a-month, extended-release injection that can treat problems with alcohol as well as heroin or pain pills. Naltrexone both reduces cravings for opioids and prevents people from getting high if they relapse and begin using again. Because naltrexone is not an opioid there is no potential for misuse.

The Benefits of Vivitrol

  • Vivitrol shuts down those pesky opioid receptors, reducing cravings and preventing you from getting high if you take an opioid.
  • Because naltrexone is not an opioid, providers can prescribe it without jumping through extra federal regulation. This may mean easier access for you.
  • Vivitrol is also an extended-release injection that is given on a monthly basis so you don’t have to worry about taking a pill every day.

Trade-offs with Vivitrol

  • Before starting Vivitrol, you must have gone through a full opioid detox 7-10 days in advance. This can be tough to do.
  • Naltrexone can reduce opioid tolerance and cause sensitivity to the same, or even lower doses of opioids. This increases risk of overdose.
  • Vivitrol is administered as an injection, given in a clinic, doctor’s office, or at a pharmacy that is willing to give injections. This means you have to locate one of these facilities and then visit it monthly to be given your shot.
  • Because Vivitrol is a time-release shot, its effects last 28 days. If you need opioid therapy for pain, say in an emergency situation, special measures will need to be taken. Consider carrying a Vivitrol Pain Management Card; a blank one can be downloaded here. Workit Health prescribes Vivitrol treatment only in California, but does offer naltrexone in many states.

So which is better?

Suboxone and Vivitrol both have pros and cons. The best recovery med for you depends on your unique situation and recovery goals. A recent study comparing Suboxone and Vivitrol head-to-head found they were equally effective at reducing cravings and treating addiction, BUT the 7-10 day detox period before Vivitrol treatment caused some users to drop out of the study before receiving treatment. Your long-term treatment plan may include both Suboxone and Vivitrol.

Ali Safawi was an intern with Workit Health from May to August 2018. He is a graduate of the University of Michigan.

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. Workit Health, Inc. and its affiliated professional entities make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.

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