Suboxone vs. Vivitrol: Which Is Better for Treating OUD?

Vivitrol and Suboxone are both Medication for Addiction Treatment (MAT) solutions for people with opioid use disorders (OUD). They’re similar, but important differences separate them.

Suboxone eases withdrawal symptoms, and it’s often the first medication people use as they enter recovery. Vivitrol reduces cravings, and it’s used to support sobriety later in the treatment process. 

What Is Suboxone?

Suboxone is a prescription medication that eases opioid withdrawal symptoms and cravings. 

The main ingredient in Suboxone is buprenorphine, a partial opioid agonist. Buprenorphine reduces cravings and withdrawal symptoms without causing intoxication.[1]

Suboxone also contains naloxone, an opioid antagonist. Naloxone prevents Suboxone from being used to get high, as it becomes active if the drug is tampered with.[1]

When taken as medically directed, Suboxone has a lower risk of misuse than other opioids and little overdose potential.[1] But it can cause physical dependence, so you’ll need help when you quit taking it. And it can be intoxicating for people with no history of chronic opioid use.

What Is Vivitrol?

Vivitrol is a prescription medication for opioid use disorder or alcohol use disorder (AUD). People start using Vivitrol when they’ve quit drinking or using drugs and want to preserve their sobriety. 

Vivitrol’s active ingredient is naltrexone, which blocks the intoxicating, euphoric and sedative properties of both alcohol and opioids. It works by binding to the body’s opioid receptors.[2]  

Vivitrol is not intoxicating, and it doesn’t cause physical dependence. If you don’t drink or use opioids while on Vivitrol, you won’t notice it’s there. 

Comparing Vivitrol & Suboxone 

If you’re struggling with OUD, medications can be incredibly useful. Pharmaceutical solutions can help you stay engaged with sobriety longer, so you can change your life for the better. 

Both Vivitrol and Suboxone can be used this way. But important differences separate them.[3-6]

* These side effects are specific to people using Vivitrol for OUD

** These side effects are specific to the strip form of Suboxone

What Makes Them Similar?

Vivitrol and Suboxone are MAT options for people with OUD. They bind to receptors in the brain and body, blocking your ability to get high. 

If you use drugs on Vivitrol or Suboxone, the medications cap your receptors. With nothing to latch to, your drugs will not work. This function could ensure that a slip doesn’t turn into a full-blown relapse. 

What Makes Them Different?

Vivitrol and Suboxone are different in multiple ways, including the following:

• Ingredients: Suboxone contains buprenorphine/naloxone. Vivitrol contains naltrexone. The partial opioid agonist (buprenorphine) in Suboxone sets it apart from Vivitrol, which contains only an agonist. 
• Conditions treated: Vivitrol can treat AUD and OUD. Suboxone is only for OUD. 
• Administration: Suboxone is available in tablets and strips that dissolve in your mouth. Vivitrol is delivered by injection (from a doctor or other healthcare professional).
• Use: Most people take Suboxone daily. Vivitrol is delivered in a monthly injection.
• Privacy: You must go to a doctor’s office to get your Vivitrol shot. You can fill a Suboxone prescription at a pharmacy and use the medication at home. 
• Costs: Suboxone is much less expensive than Vivitrol. Generic versions are even more affordable than the name-brand products. And you won’t have to pay a doctor to inject it. 
• Misuse potential: It’s hard for people with OUD to get high with Suboxone, but others with no such history can misuse it. Vivitrol has no such risks. 
• When to start it: You can use Suboxone to ease withdrawal symptoms, so you can start it within a day or two of quitting opioid misuse. You must wait much longer to start Vivitrol. 
• Symptom control: Suboxone can lessen withdrawal symptoms and cravings. Vivitrol just blocks the action of drugs, so it can’t make your withdrawal better. 

Choosing the Right Medication for You

Both Vivitrol and Suboxone can be helpful MAT options. While you can’t use these two solutions together, it’s not uncommon for people to switch from one to the other in recovery.

Suboxone

Suboxone is typically the best choice for early recovery. Buprenorphine is the most important ingredient in Suboxone, as it binds to the brain’s opioid receptors, reducing cravings and withdrawal symptoms. You can start taking it between 12 and 72 hours after your last opioid hit. The naloxone prevents you from misusing your medication. 

Taking a medication that reduces craving and the impulse to use opioids allows the individual to focus on other aspects of the recovery process, like learning to cope with strong emotions and healthy behaviors in counseling and group therapy. As a result, Suboxone treatment results in lower relapse rates and better chances of long-term recovery.

But Suboxone contains a partial opioid agonist, and buprenorphine can cause physical dependence. It may also make you feel sedated or constipated. Sometimes, people want an MAT solution that doesn’t have these risks. 

Vivitrol

Vivitrol is a blocker only. It won’t prevent withdrawal symptoms, and its chemical function won’t ease cravings. 

If the person does relapse while Vivitrol is in their body, the lack of high from the intoxicating substance will not reinforce future use of that substance in the same way. The person may learn at a subconscious level that they do not want to consume these substances.

A person must abstain from opioids for 7 to 14 days before beginning Vivitrol. Sometimes, people switch from Suboxone to Vivitrol as a step-down form of MAT. They still have relapse prevention, but they’re not taking a medication linked to dependence. 

Which Is Right for Me?

It depends. Your doctor can help you understand what medication is best for you, your lifestyle and your recovery. 

Vivitrol vs. Suboxone FAQs