We provide treatment for opioid dependence and addiction with a medication called Buprenorphine (also known as brand names Suboxone, Subutex and Zubsolv.) Buprenorphine is the active part of the medication and is considered a “partial opioid agonist.” This simply means that it produces a milder form of the opioid effect (as compared to other opioids, which are “full agonists” and produce a much stronger effect.)
The advantage of using Buprenorphine is that it fills the brain’s opioid receptors without producing the “high” that other opioids produce. Thus, the potential for abuse is much less. In the meantime, it provides excellent relief from withdrawal symptoms and cravings, making it very effective in helping patients get off other opiates.
Another advantage of Buprenorphine is that it actually binds much more strongly to the brain’s opioid receptors than any of the other opioids do. Thus, it essentially blocks the other opioids from working, and takes away the incentive to use them.
Vivitrol is an injectable form of naltrexone, which is a pure opioid blocker. It covers the opioid receptors in the brain, preventing any opioids from binding to those receptors. Essentially, this means that opioids cannot exert any effect even if they are used. This takes away the incentive to use opioid drugs.
Oral naltrexone has the same effect. However, the long-term problem with oral naltrexone is that it must be taken daily in order to continue its benefit as the effect only lasts for a day or so. On the other hand, the injectable naltrexone (Vivitrol), lasts for a whole month!
Vivitrol is only appropriate for those patients who have successfully managed to discontinue all opioids, including Suboxone, for at least 7-10 days (or 14 days if coming off of Methadone.) Patients who are abusing alcohol or are drinking in excess may also benefit from Vivitrol as it helps to reduce cravings for alcohol.
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