The effects of opioids and overdose can be extremely detrimental to an affected individual’s life. That is why effective medication-assisted treatments have become crucial in fighting this epidemic.
Two potential medications that a person can take to combat Opioid Use Disorder include Suboxone and Vivitrol.
The question of what is best for a person suffering from opioid addiction is not definite and may require a careful comparison of advantages and disadvantages. This article will cover:
- What Suboxone and Vivitrol are
- A comprehensive comparison between Suboxone and Vivitrol
- Making the right choice and what factors should be considered.
Let’s begin.
What is Suboxone?
Suboxone treatment is widely used to help people with Opioid Use Disorders. It contains both buprenorphine (an opioid agonist) and naloxone (an opioid antagonist). Both ingredients work together to combat opioid withdrawal symptoms, as well as reduce the effects of overdose.
What is Vivitrol?
Vivitrol is an injectable medication containing naltrexone that is used to treat Opioid Use Disorder and Alcohol Use Disorder (alcoholism). The ingredient naltrexone is an opioid antagonist. Naltrexone blocks opioid receptors, thus preventing a ‘high’. Vivitrol also helps to block the desire to drink alcohol, ultimately helping people to resist and stay away from opioids and alcohol.
Vivitrol vs. Suboxone: A Comprehensive Comparison
Vivitrol | Suboxone | |
Method of Administration | Monthly injection by healthcare provider | Daily sublingual dissolving tablets |
Benefits | - Effective for opioid use disorders | - Cost-effective |
Side Effects and Concerns | - Nausea, dizziness, muscle cramps | - Oral hypoesthesia, nausea, insomnia |
Effectiveness and Success | Lower success rate (65% relapse) | Higher success rate (57% relapse) |
Rates | Shorter time until relapse (14 weeks) | Longer time until relapse (8 weeks) |
Cost and Accessibility | May have insurance coverage, potentially more expensive, easier prescription | May have insurance coverage, cost-effective, stricter prescription |
Method of Administration
Vivitrol differs in method of administration compared to Suboxone. Vivitrol is injected (by a healthcare provider), as a monthly shot in the buttocks region. On the other hand, Suboxone is dissolved sublingually in the mouth as either a tablet or film, with doses taken daily.
Benefits of Each Treatment
Both Suboxone and Vivitrol are effective at treating Opioid Use Disorder. Benefits include reducing cravings or withdrawal symptoms associated with discontinuing opioids, which ultimately prevents relapse.
However, both drugs also have their own additional benefits. For instance, Suboxone has the benefit of being more cost-effective and easier to administer due to being in an orally ingested form.
Meanwhile, Vivitrol has the advantage of less frequent dosing and is effective for alcoholism as well.
Side Effects and Concerns
Vivitrol and Suboxone can both come with some minor and serious side effects.
Vivitrol administration may have side effects such as nausea, dizziness, and muscle cramps. Additionally, there are concerning implications that could occur, including severe depression, allergic reactions, and pneumonia.
Suboxone can cause side effects such as oral hypoesthesia, nausea, and insomnia. More concerning is the risk of symptoms such as respiratory depression and drug misuse.
Effectiveness and Success Rates
Overall, Suboxone tends to have a higher success rate than Vivitrol. A study conducted by the Recovery Research Institute found that 65% of Vivitrol patients relapsed, compared to only 57% of Suboxone users.
The Suboxone group also had a significantly longer time until they relapsed (8 weeks vs 14 weeks). This suggests Suboxone may be more effective.
Cost and Accessibility
Getting covered for Suboxone and Vivitrol treatment by insurance is possible depending on your plan and situation. However, Suboxone tends to be more cost-effective. In terms of accessing these medications, it may be harder to get a Suboxone prescription due to it containing a partial opioid agonist.
Vivitrol vs. Suboxone: Making the Right Choice + Factors to Consider
The severity of opioid dependence
The severity of a patient’s addiction to opioids can affect the choice of treatment option.
For instance, Vivitrol requires a patient to be ‘detoxed’ or completely over their withdrawal before beginning treatment. Patients who have severe dependence may not be able to achieve that.
This means they will have to opt for medications like Suboxone, which is taken straight away to curb cravings and prevent relapse.
Patient’s history with treatments
There are several factors that can affect what choice of treatment such as previous treatment success, risk of diversion, and psychological/mental health track records.
For example, a patient who has had a history of misusing their medication may not be suitable for Suboxone treatment. This is because Suboxone contains buprenorphine, which has the potential to create dependence due to being a partial opioid agonist.
A patient may also have a history of mental health conditions which will alter what medication is best for them.
Ability to adhere to treatment protocols
As mentioned previously, the method of administration differs depending on the medication.
Vivitrol is only administered with a medical professional involved. Suboxone is a medication that patients can take back home and administer themselves.
This may increase the likelihood of Suboxone misuse and addiction, and thus a lack of adherence to treatment protocols.
Vivitrol does not pose the same risk due to the medical supervision that is involved in the treatment.
However, it is also the patient’s responsibility to ensure they are 7-10 days sober before starting treatment with Vivitrol. This is where adherence to protocols may be challenged by individuals with a severe addiction.
Underlying health conditions
Underlying health conditions may affect the choice a person should make when being treated for Opioid Use Disorder.
For example, Vivitrol requires patients to be free of any opioids in their system. On top of this, it also requires the absence of prescription pain medications and even cough, cold, and diarrhea medicines that contain opioids.
Similarly, patients aren’t able to use Suboxone if they have a mental condition such as anxiety that is currently being treated using benzodiazepines. This is due to the harmful implications that may happen when taking both medications at the same time.
Conclusion
Vivitrol and Suboxone both come with their respective advantages and disadvantages. An individual may opt for Vivitrol as a time-efficient option, or Suboxone as the less invasive and cost-friendly alternative.
Either way, getting treatment for opioid usage is a step in the right direction. It is always important to discuss with a healthcare professional what’s best for you. In particular, Suboxone should only ever be taken under medical supervision due to the potential risk of misuse.
References:
- https://www.drugs.com/vivitrol.html
- https://agapetc.com/suboxone-vs-vivitrol-shot/
- https://www.vivitrol.com/content/pdfs/medication-guide.pdf
- https://www.suboxone.com/pdfs/prescribing-information.pdf
- https://www.recoveryanswers.org/research-post/suboxone-vs-vivitrol-head-head-comparison/#:~:text=The%20Suboxone%20group%20had%20a,of%20avoiding%20relapse%20that%20week.
- https://www.matclinics.com/matclinics-blog/vivitrol-vs-suboxone
- https://www.symetriarecovery.com/blog/vivitrol-vs-suboxone/
- https://americanaddictioncenters.org/suboxone/what-happens-if-you-take-drugs-while-on-suboxone#:~:text=It%20is%20extremely%20dangerous%20to,even%20death%20if%20taken%20together.
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