When someone is working toward overcoming opioid addiction, their treatment plan might include medication-assisted treatment (MAT). Two medicines that are frequently prescribed in opioid MAT include Vivitrol and Sublocade.

When comparing Vivitrol and Sublocade, each works differently and offers its own benefits and considerations. Understanding the difference between Vivitrol and Sublocade will help you decide on the best treatment options to support your recovery process.

What is Medication-Assisted Treatment?

MAT is a key component of the fight against opioid addiction. It provides support when someone wants to reclaim their lives. Among MAT options, Vivitrol and Sublocade stand out for their effectiveness. Both medicines can help reduce cravings and prevent relapse, but they do so in different ways.

Medication-assisted treatment is an intensive approach to treating substance use disorders, including not only opioid but also alcohol use disorders. MAT combines medicines approved by the FDA with behavioral therapies and counseling for a whole-person treatment approach.[1]

The benefits of MAT include better treatment retention, reduced risk of relapse, improved quality of life and a lower risk of overdose.

What Is Vivitrol?

Vivitrol is a brand name for extended-release, injectable naltrexone. Naltrexone can be used for both opioid and alcohol dependence.[2]

Vivitrol is an opioid antagonist. It binds to the opioid receptors found in the brain but doesn’t activate them, blocking the effects of other opioids. Vivitrol is given monthly as an intramuscular injection, so it’s convenient if you don’t want to worry about taking a daily medicine.[3]

When naltrexone occupies the receptors, opioids like heroin and prescription painkillers can’t produce their typical effects like pain relief and euphoria. The blocking action reduces cravings and prevents relapse because the user doesn’t experience the pleasurable effects of using opioids.

For alcohol dependence, the way that Vivitrol works is less understood, but it’s thought to modulate reward pathways in the brain. By reducing alcohol’s reinforcing effects, Vivitrol can decrease the urge to drink.

The extended-release formulation ensures that a steady release of naltrexone is provided for a month.

Vivitrol is usually introduced once someone goes through detoxification and has been opioid-free for at least 7-10 days. If someone has opioids in their symptoms and they’re given Vivitrol, it can cause severe withdrawal symptoms.

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What is Sublocade?

Sublocade is also a brand-name medicine, an extended-release injectable form of buprenorphine.[4] For opioid dependence, buprenorphine acts as a partial opioid agonist. It activates the brain’s opioid receptors but not as much as a full agonist like heroin. Sublocade ensures a steady release of the medicine over time, like Vivitrol.

Sublocade binds to the same receptors that drugs like prescription painkillers do, but less intensely, which helps to reduce cravings and withdrawal symptoms.

Sublocade doesn’t produce the significant euphoria associated with full opioid agonists.

The medicine is beneficial if someone has stabilized on a daily oral version of buprenorphine and wants something more convenient.[5] It’s usually given after an initial stabilization period when someone isn’t experiencing significant cravings or withdrawal symptoms.

What’s the Difference Between Vivitrol and Sublocade?

Both Vivitrol and Sublocade are medicines used to treat opioid dependence, but they have significant differences.

• Mechanism of action: Vivitrol is naltrexone, which binds to opioid receptors without activating them. Sublocade also binds to opioid receptors but activates them, although to a lesser extent than other opioids.
• Administration: Vivitrol is given as a 380 mg intramuscular injection every four weeks. Sublocade is given as a subcutaneous injection every four weeks with available doses of 100 mg or 300 mg.
• Suitability: Vivitrol is for patients who have gone through detox and been opioid-free for at least 7-10 days, and it can also be used for alcohol dependence. Sublocade is intended for patients who have been stabilized on daily early buprenorphine.

Pros and Cons of Vivitrol

The pros of Vivitrol include:

• The once-a-month dosing helps with treatment adherence.
• There’s no potential for misuse, and it’s non-addictive.
• It blocks the euphoric effects of opioids.
• The medicine is also approved to treat alcohol dependence.

The cons of Vivitrol include:

• It requires detox before it can be given.
• It’s not an option for people with liver disease or if they’re on opioid pain management.
• Side effects like nausea, fatigue and headaches can occur.

Pros and Cons of Sublocade

The pros of Sublocade include:

• It’s convenient because of the once-a-month dosing.
• There’s a lower risk of misuse compared to take-home sublingual buprenorphine.
• Medication levels are consistent to reduce cravings and withdrawal.

The cons of this medicine include:

• You have to stabilize on oral, sublingual buprenorphine first.
• There are side effects like constipation, headache and nausea.
• Sublocade is only available in certain settings and treatment programs.

Vivitrol vs. Sublocade: Which is Right For You?

You should seek professional guidance when comparing Vivitrol and Sublocade and determining which is best for your needs. Your treatment team will consider your needs, medical history and personal preferences.

For example, since you have to completely detox from opioids before taking Vivitrol, if you can’t go through this period without withdrawal symptoms, it may not be a good choice, at least not initially.

There’s no potential for misuse with Vivitrol, which is another key consideration. The risk of misuse with Sublocade is low but possible.

Your treatment goals will be considered, too. For example, if you want to avoid all potentially addictive medicines and opioid effects, Vivitrol could be the right choice. If you wish for a long-acting, discrete medicine that provides stability, Sublocade could align more with your needs.

Find Treatment Now

When comparing Vivitrol vs. Sublocade, there are some big similarities and differences. A professional addiction treatment team will evaluate your detox status, risk of misuse, medical conditions, addiction type, treatment goals and more. They’ll then work collaboratively to help you make informed decisions as you begin treatment and recovery.

If you’d like to learn more about opioid addiction treatment, reach out to us at any time.

References:

1. Substance Abuse and Mental Health Services Administration (SAMHSA): Medications for Substance Use Disorders
2. UAMS Psychiatric Research Institute: What is Vivitrol?
3. U.S. Food and Drug Administration (FDA): Vivitrol
4. U.S. Food and Drug Administration (FDA): FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder
5. U.S. Food and Drug Administration (FDA): Sublocade