Vivitrol vs. Suboxone: Which one should you be taking?
If you’re asking that question, you’re probably already dealing with cravings, withdrawal, or fear of relapse and trying to make the safest choice you can without becoming “dependent on another drug” or blowing up your routine.
The challenge is that both medications are effective, but they’re designed for different stages of recovery and distinct needs.
In this article, we’ll break down how they compare in terms of effectiveness, withdrawal, side effects, and cost, so you can walk into your appointment ready to choose the option that actually fits your life.
KEY POINTS
- Both Vivitrol and Suboxone are effective for opioid use disorder, but they’re designed for different recovery points.
- The best choice depends on your clinical situation and lifestyle, rather than on one drug being considered “better.”
Key Differences Between Vivitrol and Suboxone
Before deciding which medication may be appropriate for you, it is helpful to understand the differences between Vivitrol and Suboxone at a high level. Here’s a quick overview of these two:
Medication type
Vivitrol is an extended-release form of naltrexone, a pure opioid antagonist. It works by blocking opioid receptors without activating them, meaning it does not produce opioid effects.
Suboxone, on the other hand, is a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that activates opioid receptors just enough to reduce cravings and withdrawal, while naloxone helps discourage misuse.
Primary indications
Vivitrol is approved for both opioid use disorder and alcohol use disorder, whereas Suboxone is approved specifically for opioid use disorder.
Timing of initiation
The timing of when each medication can be started is also different. Vivitrol must be initiated after you have fully detoxed and are opioid-free for a set period of time, because starting it too soon can trigger severe precipitated withdrawal.
Suboxone is typically started when someone is already in mild to moderate withdrawal, which allows treatment to begin earlier in the recovery process.
Route and frequency of administration
In terms of administration, Vivitrol is given as a once-monthly injection in a clinical setting.
Suboxone is taken daily at home as a sublingual or buccal film or tablet.
Dependence and discontinuation
Because Vivitrol is not an opioid, it does not cause physical opioid dependence, and stopping it does not result in opioid withdrawal.
Suboxone is opioid-based, so physical dependence is expected, and discontinuation usually requires a slow, medically supervised taper.
Adherence and lifestyle fit
Lifestyle fit matters as well. Vivitrol can be a good option for people who struggle with daily medication adherence or prefer a once-monthly approach.
Suboxone may be better for those who can reliably take a daily medication and benefit from dose flexibility over time.
How Well Do Vivitrol and Suboxone Work?
Both Vivitrol and Suboxone are considered effective, evidence-based treatments for opioid use disorder. The key point is that they support recovery in different ways.
Suboxone partially activates opioid receptors, which means it can significantly reduce withdrawal symptoms and cravings, especially in early recovery. For many patients, this makes it easier to stabilize, attend therapy sessions, and stay engaged in their treatment.
Vivitrol blocks opioid receptors without activating them. It is most effective after detox, when you are already opioid-free and want strong protection against relapse and a medication that is not itself an opioid.
Once you are successfully started on either medication and supported with counseling and structured care, outcomes can be comparable.
The better choice for you usually depends on your current use, your ability to complete detox, and your goals.
Withdrawal and Transitions Using Vivitrol vs. Suboxone
Where many people get stuck is not just “Vivitrol vs. Suboxone,” but when and how each medication can be started.
Starting Suboxone
Suboxone is typically initiated once mild to moderate withdrawal has begun. It helps ease withdrawal symptoms and cravings as you stop using short-acting opioids, allowing treatment to start earlier—even while discomfort is still present.
Starting Vivitrol
Vivitrol requires full detoxification. You must be completely opioid-free for a period of time before starting it. If opioids are still in your system, Vivitrol can trigger sudden and severe precipitated withdrawal. For this reason, it is usually introduced after detox or later in a recovery plan.
Stopping the medications
Stopping these medications also differs. Suboxone should never be stopped abruptly, as withdrawal can occur. A gradual, medically supervised taper is essential.
Vivitrol does not cause opioid withdrawal when discontinued, but cravings can return if there is no ongoing treatment or support plan.
Note that you should never try to start, switch, or stop either medication on your own.
These decisions should be guided by a behavioral health specialist and a medical team that is familiar with your complete history.
Side Effects and Safety
All medications carry potential side effects. Knowing what is common, as well as what is rare, helps you make an informed decision.
Suboxone: Common side effects
Common side effects of Suboxone include headache, nausea or constipation, sleep disturbances, sweating, and mild fatigue.
Because it is an opioid-based medication, there is some risk of misuse or diversion, which is why careful prescribing, monitoring, and a strong provider relationship are critical.
Vivitrol: Common side effects
Common side effects of Vivitrol include injection-site pain or soreness, nausea, headache, and fatigue.
A key safety issue with Vivitrol is loss of opioid tolerance. If someone stops Vivitrol and returns to previous levels of opioid use, the risk of overdose increases significantly.
This is why ongoing medical and behavioral support matter just as much as the injection itself.
For both medications, honest communication about your use, other substances, and medical conditions is essential to keeping you safe.
Begin Your Path to Safer, Stable Recovery
Choosing between Vivitrol and Suboxone is not something you need to figure out on your own.
The most important step you can take is to be honest about where you are in your recovery and sit down with a team that understands both the medications and the realities of your daily life.
At Northview Wellness in Norcross, GA, your care is led by physicians specializing in addiction medicine within a CARF-accredited program.
If you are ready to explore which option is right for you, we invite you to schedule a confidential evaluation.
Call Northview Wellness at (678) 626-1868 or request an appointment online to take the next step toward a safer, more stable recovery.
FAQs
Is Suboxone cheaper than Vivitrol?
Often, yes, per dose, especially in generic form. But Suboxone is taken daily, so ongoing pharmacy co-pays apply. Vivitrol costs more per injection but is only monthly. Your actual cost depends on your insurance and benefits.
Which medication is more convenient: Vivitrol or Suboxone?
Suboxone may be more convenient if you’re comfortable taking a daily medication and want flexible dosing. Vivitrol may be a better fit if you prefer a once-monthly visit and don’t want to manage daily pills or films.
How often do I need to take each medication?
Suboxone is taken once daily at home. Vivitrol is administered once every four weeks as an in-office injection.
