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.
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.
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.
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]
VivitrolSuboxoneConditions treatedAUD and OUDOUD When is it used?After detox During and after detox Active ingredients NaltrexoneBuprenorphine and naloxone Causes physical dependence?NoYesAddiction potential Absent Low How is it administered?InjectionDissolving strip or tabletHow long does a dose last?30 days1 day Typical side effectsHepatic enzyme changes, injection site pain, cold-like symptoms, insomnia and toothache*Mouth numbness or burning sensations, headache, nausea, vomiting, constipation and insomnia** Typical monthly cost without insurance $1,550 $275Generic version available?NoYes
* These side effects are specific to people using Vivitrol for OUD
** These side effects are specific to the strip form of Suboxone
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.
Vivitrol and Suboxone are different in multiple ways, including the following:
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 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 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.
It depends. Your doctor can help you understand what medication is best for you, your lifestyle and your recovery.
Does Vivitrol block Suboxone? Yes. Vivitrol can stop the agonist effects of Suboxone. You should always consult with your medical provider about the safe time frame and protocol for switching from Suboxone to Vivitrol if that interests you.
Is Vivitrol the same as Subutex? No. Subutex is a buprenorphine-based medicine like Suboxone. Vivitrol is an extended-release naltrexone shot.
How long after Suboxone can you take Vivitrol? You must wait until your body completely metabolizes the last Suboxone dose you took. The recommendation is to wait at least 7 to 14 days, but always work with your medical provider to determine what is best for you.
Is naltrexone the same as naloxone? No. Naltrexone and naloxone are both opioid antagonists, meaning they kick opioids off the brain’s opioid receptors, so they are similar. However, naltrexone, especially when given as an injection, remains in the body for a long time, while naloxone metabolizes within a few hours.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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