A once-monthly shot for opioid addiction called Vivitrol, is as effective in maintaining short-term abstinence from heroin and similar drugs like Suboxone, according to a Norwegian study.
The study is believed to be the first to directly compare Vivitrol vs. Suboxone. Here in the US, Suboxone and methadone have been the standard medical treatment for people with opioid addiction. However, researchers in Norway found the two treatments were similar regarding safety and efficacy when it came to assisting opioid-dependent people to refrain from illicit drug use during a three month period.
Many addiction specialists are waiting for more research about Vivitrol before considering it as a treatment option. A larger study done to compare Vivitrol vs. Suboxone, funded by NIDA, is expected to be released in December of this year. That study tracks subjects for a longer period. Other studies are also underway.
Vivitrol Shot VS Suboxone
Vivitrol is a version of the drug naltrexone and is a once-monthly shot for opioid addiction that blocks the euphoric and sedative effects of opioids. Suboxone is an opioid itself, comprised of buprenorphine and a small amount of naloxone. Suboxone produces less of a euphoric effect than other opioids like heroin. Suboxone and methadone have been well-studied and have shown to be effective in keeping people in treatment centers and reducing illicit opioid use.
The federal government has recently called for expanded access to medications for treating opioid abuse or MAT (Medication Assisted Treatment). Most inpatient treatment centers in the US are abstinence-based, and their standards for success usually require a subject to be free of all substances. Although many treatment centers do advocate for the Vivitrol shot for opioid addiction, many treatment centers and individuals are against the use of Suboxone and methadone because they are opioids and they require being taken daily. People taking these medications can function at a high level and are not considered addicted. But, in other countries, people using Suboxone as a treatment for opioid dependence are barred from certain jobs, such as operating heavy machinery or driving a car.
In the United States, Vivitrol has been highly marketed to drug court judges and prison officials as a monthly shot for opioid addiction. Some in law enforcement favor the use of Vivitrol shot vs. suboxone because it is not an opioid and only needs to be given once a month, rather than a daily dosage. Others have been critical of that approach, saying it unfairly stigmatizes the effective use of Suboxone and methadone in treating people with opioid addiction.
Back to the Vivitrol Study
As for the Norwegian study, it randomly split 159 patients into two groups, one group getting the Suboxone and one group getting the Vivitrol. The study participants knew which treatment they were receiving which could have resulted in bias. The researchers reported patients in both groups stayed in the study for similar lengths of time (around 60 days); about a third of the patients dropped out of the study. There was little difference between the two groups in the number of patients testing positive for illicit drug use during the study.
Does Vivitrol Block Suboxone?
Yes, Vivitrol blocks the effects of all opioids in the brain. Vivitrol is a blocker; if someone took suboxone on Vivitrol, there would be no euphoric effect in the user. This does not mean that while on the monthly shot for opioid addiction that you cannot overdose by using opioids. When people attempt to override the blocking abilities of the Vivitrol shot it can cause an overdose death. Though they aren’t feeling the euphoric effects of the illicit drugs, it is still accumulating in their body. This is why it is very important for those on the Vivitrol shot or any other form of MAT to remain abstinent from all drugs.
While Vivitrol blocks the effects of opioids, it doesn’t block the high from other drugs. While taking the shot for opioid addiction, people can still abuse other drugs. It is extremely important that anyone on Vivitrol or suboxone also goes to therapy or an outside group such as 12-step fellowships meetings. Medication-assisted treatment is not a cure for addiction; it is a stepping stone to stop actively using substances and pursuing an abstinence-based life.