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Vivitrol vs. Suboxone: Comparing MAT Medications

In MAT programs, medications are used in combination with therapy to support people through the detox process and encourage long-term recovery. While both Vivitrol and Suboxone can support ongoing recovery, they work in different ways to treat OUD.

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Vivitrol and Suboxone are two medications used in medication-assisted treatment (MAT) of opioid use disorder (OUD). In addition, Vivitrol is sometimes used to treat alcohol use disorder (AUD).

Understanding Vivitrol & Suboxone for OUD

Vivitrol and Suboxone are prescribed by medical professionals to help return brain chemistry back to normal when a person has a history of opioid misuse. They help treat addiction to various opioids, including heroin, morphine, codeine, oxycodone, and hydrocodone

By reducing cravings and relieving withdrawal symptoms that often inhibit recovery, Vivitrol and Suboxone help people recover from an opioid addiction. These medications are considered safe to take for both the short-term treatment and the long-term management (potentially for a lifetime) of OUD.[1]

How Does Vivitrol Work?

Vivitrol is a brand name version of naltrexone, an extended-release drug that blocks the pleasurable effects of opioids. It helps to prevent relapse in individuals in recovery from OUD by binding to receptors in the brain for up to one month. By blocking opioid receptors, cravings and urges to use opioids are greatly reduced.[2]

How Does Suboxone Work?

Suboxone is a combination of buprenorphine and naloxone. It is offered as a sublingual film as well as a tablet. Both forms of Suboxone are placed under the tongue. As the film or tablet dissolves, the medication is absorbed into the bloodstream. 

Like Vivitrol, the buprenorphine in Suboxone works by binding to opioid receptors in the brain. This successfully reduces opioid withdrawal symptoms and cravings, helping users to maintain recovery from opioid abuse.[3]

Comparing Vivitrol & Suboxone 

This chart breaks down the similarities between Vivitrol and Suboxone when use to treat OUD:[3,4]

Vivitrol Suboxone
UseShort-term and long-term treatment of OUDShort-term and long-term treatment of OUD
FormsIntramuscular injectionSublingual film or tablet 
How They Are UsedInjected under the skin as an extended-release treatment Placed under the tongue to dissolve
Common Side EffectsNausea, sleepiness, headache, dizziness, vomiting, lowered appetite, painful joints, cold symptoms, difficulty sleeping, toothache, reaction at injection site, allergic reaction, pneumonia, and depressed moodConstipation, nausea, vomiting, headache, dizziness, drowsiness, fatigue, sweating, dry mouth, tooth decay, muscle aches and cramps, difficulty sleeping, fever, blurred vision, tremors, heart palpitations, reduced attention, and respiratory distress
Addiction PotentialNoLow
Insurance CoverageYes, though exact coverage varies by planYes, though exact coverage varies by plan
Efficacy & SafetyConsidered safe and effectiveConsidered safe and effective 

Key Differences Between Vivitrol & Suboxone

Vivitrol and Suboxone have key differences. Though they are both designed to treat OUD, their differences may make one drug more appropriate for one person than for another. Preferences on whether you plan to take your medication in an inpatient or outpatient setting or how often you wish to take it can impact which medication is right for you. 

Here are the primary differences:

Route of Administration 

One of the primary differences between Suboxone and Vivitrol is how they are administered. Because it is available as an injectable solution for the treatment of OUD, Vivitrol can only be administered by a trained professional in a healthcare setting. Improper injection by untrained individuals can lead to serious health complications.[4]

Suboxone is a much simpler medication to take. It is prescribed by a healthcare professional but safe to self-administer under the tongue in a treatment setting as well as at home. The ability to take it at home increases accessibility to this form of MAT.

How Long the Effects Last

As an extended-release medication, a single dose of Vivitrol lasts much longer than a dose of Suboxone. One injection of Vivitrol contains enough medication to control opioid withdrawal and cravings for up to one month.[4]

With Suboxone, once the film or tablet is placed under the tongue, it takes approximately 15 to 30 minutes to dissolve and enter the bloodstream. The effects are meant to last for a day, and a new film is required each day.[6] The effects are felt quite quickly but also do not last as long as a Vivitrol injection does. 

When They Can Be Started

Once in the system, both Vivitrol and Suboxone reduce craving and withdrawal symptoms. However, Vivitrol cannot be administered until at least a few days or a week after the last use of opioids. 

Your doctor will determine the appropriate dose for you. Doses differ when the medication is used to treat OUD versus AUD. 

Suboxone can be taken nearly right away once moderate signs of withdrawal occur. For people receiving outpatient treatment, Suboxone may be a safer choice as the waiting period between opioid abuse and treatment is shorter.[5]

Choosing The Right Medication for Opioid Use Disorder

Vivitrol and Suboxone are two of the most commonly prescribed medications for the treatment of opioid abuse and addiction. They are both considered safe to take in both the short and long term. 

The right medication for you depends on your personal history of opioid misuse, your goals for treatment, your lifestyle, and your support network at home. Some people enjoy the freedom that comes from getting a monthly injection versus remembering to take a pill or film strip every day. 

Your treatment team will talk to you about your opioid abuse history and current situation to determine the best path forward for you. Together, you can create a treatment plan that fits your needs and effectively gets you on the path to long-term recovery. 

Updated April 6, 2024
  1. Medications for Substance Use Disorders. Substance Abuse and Mental Health Services Administration. Published February 1, 2024. Accessed March 29, 2024.
  2. What is Vivitrol? University of Arkansas for Medical Sciences Psychiatric Research Institute. Accessed March 29, 2024.
  3. Buprenorphine. Substance Abuse and Mental Health Services Administration. Published March 8, 2024. Accessed March 29, 2024.
  4. Naltrexone. Substance Abuse and Mental Health Services Administration. Published January 30, 2024. Accessed March 29, 2024.
  5. Lee, J., Nunes, E., Novo, P., Bachrach, K., Bailey, G., Bhatt, S., Farkas, S., Fishman, M., Gauthier, P, Hodgkins, C., King, J., Lindblad, R., Liu, D., Matthews, A., May, J., Peavy, M., Ross, S., Salazar, D., Schkolnik, R., Shmueli-Blumberg, D., and Rotrosen, J. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. The Lancet. 2018;391(10118):309-318.
  6. Buprenorphine/naloxone (Suboxone) home dosing: rapid 2-day home dosing plan. My Health: Government of Alberta. Accessed March 29, 2024.
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