Can you describe the difference between Suboxone and Vivitrol?
Suboxone is a partial agonist so this is for people who are really, really struggling with opioid cravings. It fills some of the opioid receptors but doesn’t get a person high. It’s kind of like you have a key and you put it in the door but it doesn’t turn all the way. Suboxone blocks the opioid receptors, but without getting someone high. It helps a lot with cravings. Clients are not as vulnerable when they are in a situation when they could use. It gives them a little more control. It’s like when you go to the supermarket and you’re really hungry, versus when you had a snack or a smoothie before. I explain it to my patients this way. It gives them an edge over the craving.
Vivitrol, which is a monthly shot we provide in our office, works very differently. This one basically blocks the receptors for a month. It is not an opioid. It helps with the cravings for sure, but not to the same degree. It’s an opioid blocker so even if the patient had a weak moment and they relapsed they don’t get any reward from the relapse. They get the feeling of guilt and upset, they feel like they lost their money, and they didn’t get anything in return. They know that their receptors are blocked for a month, so there is no way to go back. You can’t reverse it. So then it gives them one month of sobriety.
We give them a second shot, and it gives them a second month of sobriety. So once we add up to six or seven months, hopefully the habit is less intense and they are able to be successful. They’ve had a chance to learn all the recovery behaviors.
It’s extremely, extremely helpful. And one big thing as well — because these two medications occupy part of the opioid receptor, even if a person relapses, they don’t die. This is a huge deal because at the end our target is for people to stay alive.