Naltrexone and Suboxone are two medications commonly used as a part of medication-assisted treatment to treat Opioid Use disorder.
While both have the same common goal, each medication differs slightly in its function and objective – making it potentially difficult to decide which one is right for you.
To help you out, this guide will cover:
- What Suboxone and Naltrexone are
- A comparison of each medication, including how they work
- Advice on choosing which one is right for you.
Let’s get into it!
What is Suboxone?
Suboxone is a medication that is frequently used to treat Opioid Use Disorder.
It is composed of two different active ingredients, buprenorphine and naloxone, which work together to minimize the effects and withdrawal symptoms of opioids present in the body. It also helps to reduce further opioid cravings.
What is Naltrexone?
Naltrexone is another medication often used to treat Opioid Use Disorder. In addition, it is also used to treat alcohol use disorder.
As an active ingredient, Naltrexone works to reduce cravings as well as diminish any sedative or euphoric effects caused by opioids. It is commonly sold under the generic brand name “Vitriol” and is also commonly known as “extended-release Naltrexone.”
Comparing Naltrexone Vs Suboxone: Their Key Differences
How They Work In The Body
While they are both effective treatments, Suboxone and Naltrexone work in a very different manner within the body. This is due to the fact that the former is a partial agonist.
Suboxone works by binding the receptors in the brain that are also used by opiates and preventing other drugs from occupying them, thereby giving its status of a “partial opiate.”
The medication produces mild sedative and euphoric effects typically experienced during opioid use to help reduce withdrawal symptoms, and it also blocks the effects of existing opioids in the system (including cravings).
On the other hand, Naltrexone is not a partial opiate and is instead an opioid antagonist – working by binding to opioid receptors within the brain and inhibiting their effects altogether (as opposed to blocking them off from other substances).
This allows for cravings for opioids to be significantly reduced, subsequently decreasing the chances of relapse.
Treatment Objectives (Prevention vs. Maintenance)
While both are used to treat Opioid Use Disorder, Naltrexone and Suboxone have different objectives.
Suboxone’s main objective as a treatment for Opioid Use Disorder is to prevent opioid withdrawal symptoms, as it helps the body to adjust to no longer consuming opioids and experiencing their effects.
It is very effective at preventing opioid overdoses, as well as lowering the risk of relapse in the early days of recovery.
Alternatively, Naltrexone’s objective as a treatment for Opioid Use Disorder is usually heralded as being a maintenance medication as it reduces further cravings for opioids.
It does not have the same withdrawal-reducing effects that Suboxone has, and is instead used as a tool to prevent relapse from occurring.
Administration Methods And Frequency
The two medications also differ in the way and frequency at which they are administered.
Suboxone is taken as either a sublingual film or tablet that is placed under the tongue and slowly dissolved. Usually, it is prescribed as a daily dose, as the effects of the medication tend to last 24 hours.
This differs from Naltrexone, which is administered as either an oral tablet or as an extended-release Naltrexone injection.
For oral Naltrexone, patients receive 350 mg of the medication per week, and this can be split up to be daily, every other day, or every third day. The injection is usually administered once every four weeks.
Side Effect Profiles
Both medications come with side effects. While most are not severe, it is important that you report any usual symptoms to your doctor immediately.
Common side effects of Suboxone include;
- Headache
- Constipation
- Dizziness
- Sweating
- Numb mouth
- Nausea and vomiting
- Painful tongue.
The side effects of Naltrexone are quite similar to those of Suboxone and include:
- Tiredness
- Sleep problems
- Joint and muscle pains
- Nausea, vomiting
- Abdominal pain and cramps
- Headache
- Anxiety
- Chronic pain.
Benefits
There are many advantages to both medications, and both are very effective at treating Opioid Use Disorder.
The advantages of Naltrexone are that there is no potential for abuse as it is not a partial opiate and that it is available as an extended-release injection.
As such, it requires less frequent administration. Additionally, it can be broadly used for both alcohol and opioid dependence.
Suboxone’s advantages lie in its ability to effectively reduce the withdrawal symptoms of opioids.
While it may be a “partial opiate”, there is a “ceiling” of how strong the opiate-like effects are thanks to its use of buprenorphine (which is an opioid agonist). This means that there is little risk of overdose.
Furthermore, the Naloxone component of Suboxone deters intravenous misuse, making it an ideal solution for recovering addicts.
How to Choose the Right Treatment
Choosing between Naltrexone and Suboxone is a matter that is unique to you.
The decision should be made in conjunction with advice and assessment from licensed healthcare providers in order to ensure you are on the right medication-assisted treatment plan.
A general rule of thumb is that Suboxone is administered to those who are actively taking opioids, as it will help to diminish the withdrawal symptoms and ensure the body adjusts to no longer using opioid drugs.
On the other hand, Naltrexone is suitable for those wanting long-term maintenance and reduction of opioid cravings.
The Bottom Line
When used as a part of a medication-assisted treatment plan, Suboxone and Naltrexone are both highly effective at managing opioid dependency and addiction. Both also have unique benefits that can help you on your journey to recovery.
No matter what, it is important that you use either medication under the supervision of a medical professional.
Both medications have a delicate balance between their benefits and their side effects, and a medical professional can help you to manage any adverse effects. This allows you to continue with your recovery journey in an effective and safe manner.
Sources
- https://www.recoverycare.org/blog/what-is-suboxone-4-facts-every-patient-should-knowhttps://www.recoverycare.org/blog/what-is-suboxone-4-facts-every-patient-should-know
- https://www.nps.org.au/assets/medicines/fa4e602b-6f34-4490-a55c-a7ae010ff79d.pdf
- https://www.drugs.com/medical-answers/how-does-suboxone-work-3557483/
- https://www.eleanorhealth.com/blog/naltrexone-suboxone
- https://www.bicyclehealth.com/opioid-education/differences-between-vivitrol-naltrexone-suboxone
- https://www.nps.org.au/radar/articles/buprenorphine-with-naloxone-suboxone-sublingual-film-for-opiate-dependence
- https://www.mayoclinic.org/drugs-supplements/naltrexone-oral-route/proper-use/drg-20068408
- https://americanaddictioncenters.org/suboxone/side-effects
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