Q: “Whats the difference between Suboxone, Methadone and Vivitrol?”
A: The difference is huge. Here are the basics in a nutshell:
In short, if a patient is really ready to get better, then Suboxone (Buprenorphine) is best.
If however the patient is not really ready and still wants to get high occasionally and cannot be trusted to take Suboxone on their own, then the short leash of Methadone daily dosing could be good for them.
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Vivitrol is best used when a patient has little control and needs to be kept safe with a blocker. Most patients say that being on Vivitrol is like torture because they are not able to use but still have the cravings.
Suboxone, Bunavail, Zubsolv, Sublocade (Inj)
- + (Is a blocker and contains an injection blocker)
+ + Gets rid of withdrawal, “sick” and craving
- + Better lifestyle, the patient gets a monthly prescription
- + Does not build a tolerance. As time goes on the patient can taper off. It is not addictive.
- + Allows the brain to heal by not stimulating the Opioid receptors.
- + Can be given as a monthly injection
- + Very few if any side effects. Rare, short term headache and possible nausea.
Methadone
(Not a blocker, it is a time released oral form of Heroin)
+ Gets rid of withdrawal, “sick” and craving
- – – Poor lifestyle; the patient must go for daily visits to the clinic for dosing.
- – – Builds a tolerance. As time goes on the patient needs more and more.
- – – Does not allow the brain to heal because it does continue to stimulate the Opioid receptors.
- – Since its not a blocker a person can use other opioids right on top of it.
- – Side effects,
- Sedation, constipation, anxiety, nervousness, restlessness, sleep problems (insomnia), weakness, drowsiness, dry mouth, nausea, vomiting, diarrhea, constipation, loss of appetite, decreased sex drive, impotence, difficulty having an orgasm, shallow breathing, hallucinations, confusion, chest pain, dizziness, fast or pounding heartbeat, trouble breathing, lightheadedness.
Vivitrol
+ – (Only an opioid blocker)
– – – Does NOT get rid of withdrawal symptoms, “sick” and craving.
- – – Better lifestyle i.e. monthly injection (however it only lasts 3 weeks but can only be given every 4 weeks so there is 1 week with no protection.) It makes ODs more common in that 4th week.
- + Allows the brain to heal by not stimulating the Opioid receptors.
– – Side effects, nausea, headache, dizziness, anxiety, nervousness, restlessness, irritability, tiredness, loss of appetite, increased thirst, muscle or joint aches, weakness, sleep problems (insomnia), decreased sex drive, impotence, or difficulty having an orgasm.
In short, if a patient is really ready to get better, then Suboxone (Buprenorphine) could be best. Suboxone is a blocker and has an added blocker against injection.
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If however the patient is not really ready and still wants to get high and cannot be trusted to take Suboxone on their own and comply with program rules, then the short leash of the Methadone daily dosing protocol could be best for them.
Vivitrol is best used when a patient has little control and needs to be kept safe with a blocker. Many times younger people do not yet have the ability or desire to remain consistently in treatment with Suboxone or Methadone and are at high risk of overdose.
Vivitrol can keep them safe for a while (lasts about 3 weeks but the shot is given every 4 weeks leaving a window of opportunity for the patient to use and since they have been craving for 3 weeks and may feel the need to overcome residual Vivitrol blocking effects, they may use more than usual and are at higher risk of overdose.
Most patients say that being on Vivitrol is like torture because they are not able to use but still have the cravings.
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