In the U.S. in 2017, there were more than 70,200 drug overdose deaths, and about 68 percent of these cases involved an opioid, according to the U.S. Centers for Disease Control and Prevention. Every person who abuses opioids and struggles with addiction is at risk for an overdose and related issues.
Comprehensive treatment can help people to become sober.
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When medications are included in treatment, Vivitrol and Suboxone are among the most common options. Learn more about how these medicines can help people to be more informed about their treatment.
What Is Vivitrol?
Vivitrol is an extended-release version of naltrexone. This medication is a type of opioid antagonist. It comes in the form of a suspension that is injected.
Vivitrol helps to treat opioid addiction by blocking the effects that opioids have on the body. This means that the person using Vivitrol will not experience the euphoria and other pleasurable effects that cause them to want to use opioids.
The goal is to reduce a person’s cravings for the drug so that they are not tempted to relapse.
This medication can also help to reduce the temptation to use opioids since the drug will block the effects and cause someone to experience unpleasant symptoms of opioid withdrawal. It is imperative that people not use any opioids when they are taking this medication. If opioids are used, it can cause the person to experience the symptoms of opioid withdrawal. Before administering this medication, the general recommendation is for people to avoid using any opioids for 72 hours.
It is possible to experience side effects when using this medication, such as:
- Muscle cramps
- Abnormal liver function tests
- Tooth pain
- Nausea, appetite changes, or vomiting
- Drowsiness or dizziness
- Stuffy nose
- Injection site swelling, itching, or pain
This medication is not ideal for all people. The following might be contraindicated with Vivitrol, according to the U.S. Food and Drug Administration:
- Using other illicit drugs
- Liver or kidney issues
- Pregnancy and breastfeeding
- Bleeding issues, such as hemophilia
This medication only needs to be taken one time per month. Those receiving it will go to their doctor, and the medication will be injected. In most cases, the doctor will inject this medicine into a muscle in the buttocks. This may cause minor discomfort, but the injection only takes a couple of seconds to complete.
It is important to have the injection done at the same time every month. People who are on this medication should carry a card with them so all health care providers will be aware.
What Is Suboxone?
Suboxone is a medication that might be used as part of an opioid addiction treatment regimen. It is a combination of two drugs, including naloxone and buprenorphine. The drug comes in the form of a film or tablet that dissolves in the mouth.
The buprenorphine component is classified as a partial opioid agonist. This type of drug aids in alleviating the withdrawal symptoms that occur when a person stops taking opioids. The naloxone component is classified as a type of opioid antagonist. This element of the drug works to reverse the effects of opioids so that the person does not experience the pleasurable side effects.
Suboxone might be started as part of a drug treatment program. It is often combined with lifestyle changes, counseling, and other addiction interventions.
Side effects are possible when someone is taking this medication. These include:
- Feeling dizzy, faint, or lightheaded
- Side or lower back pain
- Feelings of heat or warmth
- Skin redness and flushing, especially in the neck and face areas
- Difficult or painful urination
It is important to avoid using any sedatives, sleeping medications, antidepressants, narcotics, or tranquilizers with this drug. Other contraindications may include:
- Enlarged prostate
- Trouble urinating
- Head injury
- Spinal curvature that affects breathing
- Stomach issues
- Adrenal gland problems
- Breathing or lung issues
- Gallbladder disease
- Liver, kidney, or thyroid disease
To take a dose, the person will need to place the film or tablet below their tongue and allow it to dissolve. They should not eat or drink while they are waiting for the medicine to dissolve. It is important never to chew or crush the films or tablets.
In most cases, people will take a dose of this medicine once a day. Doctors may start the person off on a low dose for the first few days and then gradually increase it until they achieve the maintenance dose. Dosage adjustments may be made periodically.
How Do the Drugs Compare?
Research has shown that both drugs are more effective than a placebo. Before someone starts using either medicine, it is important to compare them in light of the individual to see how they perform against each other.
A 24-week study was performed, and the research, published in The Lancet, determined that both medicines were equally effective and safe. Some of the most prominent conclusions from this study are:
- About 65 percent of Vivitrol recipients relapsed while about 57 percent of Suboxone recipients relapsed.
- During the study, those taking Suboxone had about 10 weeks free from opiates while those taking Vivitrol had about four weeks free from opiates.
- During the study, those taking Suboxone had about 81 abstinent days while those taking Vivitrol had about 39 abstinent days.
Researchers state that Vivitrol may have outperformed Suboxone because more people who received Suboxone were able to start using the medicine right away.
Another study discussed by Stat News involved Director Dr. Nora Volkow of the National Institute on Drug Abuse, which conducted the study. It determined that a monthly injection of Vivitrol was as effective as an oral daily dose of Suboxone.
The study did have a caveat, however. Before someone can start using Vivitrol, they need to have three days of sobriety from opioids. This can make it difficult for people to start getting the injections because weaning can cause withdrawal symptoms. Compared to the people taking Suboxone, this resulted in people failing to get started with Vivitrol.
Knowing more about how these two drugs compare can help people to make the right choice for their road to sobriety. These medications should be combined with other addiction treatments to offer a comprehensive approach to help people find recovery. Those interested in either medication should talk to their doctor or addiction specialist. These professionals can aid clients in determining which one may serve them best.
Opioid Overdose: Understanding the Epidemic. Centers for Disease Control and Prevention. from https://www.cdc.gov/drugoverdose/epidemic/index.html
(January-February 2018) Comparative Effectiveness of Extended-Release Naltrexone Versus Buprenorphine-Naloxone for Opioid Relapse Prevention: A Multicentre, Open-Label, Randomized Controlled Trial. The Lancet. from https://www.sciencedirect.com/science/article/pii/S014067361732812X
(November 2017) Long-Awaited Study Finds Monthly Vivitrol as Effective as Daily Pill for Opioid Addiction. Stat News. from https://www.statnews.com/2017/11/14/vivitrol-suboxone-study-nida/
Vivitrol. RxList. from https://www.rxlist.com/vivitrol-drug/patient-images-side-effects.htm
(July 2013) Vivitrol. Food and Drug Administration. from https://www.fda.gov/downloads/Drugs/DrugSafety/UCM206669.pdf
(June 2018) Suboxone Side Effects. Drugs.com. from https://www.drugs.com/sfx/suboxone-side-effects.html
(January 2015) Suboxone. Everyday Health. from https://www.everydayhealth.com/drugs/suboxone