Vivitrol vs Sublocade: What is the Difference?

Opioid addiction continues to affect millions of individuals and families across the United States. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over 6 million people aged 12 and older had an opioid use disorder in 2023.[1] The need for effective, evidence-based opioid use disorder treatment has never been more urgent.

At Bluegrass Recovery Center, medication-assisted treatment (MAT) plays a central role in helping individuals achieve lasting recovery. Two widely used medications in MAT programs are Vivitrol and Sublocade. While both are designed to treat opioid dependence and support a substance-free life, they work in very different ways.

This guide explains the key differences between Sublocade and Vivitrol, how each medication works, and how to determine which medication-assisted treatment option may be appropriate for your recovery journey.

Understanding Medication-Assisted Treatment for Opioid Use Disorder

Medication-assisted treatment (MAT) combines FDA-approved medications with counseling and behavioral therapies. It is considered the gold standard for treating opioid use disorder and other substance use disorders.

SAMHSA reports that MAT can reduce opioid use, lower the risk of overdose, and improve treatment adherence.[2] These medications help reduce withdrawal symptoms, manage cravings, and stabilize brain chemistry.

At Bluegrass Recovery Center, MAT is tailored to each individual’s medical history, substance use patterns, and treatment goals.

What Is Vivitrol?

Vivitrol is an opioid antagonist used to treat opioid addiction and alcohol dependence. Its active ingredient is naltrexone.

How Vivitrol Works

Vivitrol blocks opioid receptors in the brain. This prevents opioid drugs from producing euphoric effects. If a person uses opioids while on Vivitrol treatment, they will not experience the “high.”

Because it is an opioid antagonist, Vivitrol does not activate receptors in the brain at all. Instead, it blocks them completely.[3]

Key features of Vivitrol treatment include:

• Administered as a monthly injection
• Given as an intramuscular injection in the gluteal muscle
• Non-addictive and not a controlled substance
• Also approved to treat alcohol use disorders
  

Before starting Vivitrol treatment, patients must be fully opioid free for 7–10 days. This requirement helps avoid severe opioid withdrawal symptoms.

What Is Sublocade?

Sublocade is a partial opioid agonist used to treat opioid use disorder. Its active ingredient is buprenorphine.

How Sublocade Works

Unlike Vivitrol, Sublocade partially activates opioid receptors. As a partial opioid agonist, it produces mild opioid effects without the intense euphoria associated with drug abuse.[4]

This helps to minimize opioid cravings, reduce withdrawal symptoms, and stabilize your brain functioning. 

Sublocade maintains consistent medication levels in the body, which supports treatment adherence and reduces relapse risk.

Key features of Sublocade treatment include:

• Administered as a monthly injection
• Given as a subcutaneous injection in the abdomen
• Classified as a controlled substance
• Requires prior stabilization on oral buprenorphine
  

Patients typically begin with sublingual buprenorphine or oral buprenorphine before transitioning to Sublocade injections.

Vivitrol vs Sublocade: Key Differences

Understanding the key differences between these medications is essential when choosing between Sublocade and Vivitrol.

Mechanism of Action

The most important distinction lies in how each medication interacts with opioid receptors.

Vivitrol is an opioid antagonist, which means it blocks opioid receptors in the brain. On the other hand, Sublocade is a partial opioid agonist. In other words, Sublocade activates opioid receptors at a low level.

This difference affects how each medication treats opioid dependence and manages cravings.

Requirement Before Beginning Treatment

Starting Vivitrol treatment requires complete detox and being opioid free. Sublocade requires stabilization on sublingual buprenorphine but not full detox.

For individuals who experience opioid withdrawal symptoms quickly, Sublocade may be easier to initiate.

Effect on Withdrawal Symptoms

Vivitrol does not reduce withdrawal symptoms, while Sublocade helps control withdrawal symptoms and manage cravings.

This makes Sublocade particularly helpful during early recovery.

Risk and Classification

Vivitrol is not a controlled substance and has no abuse potential. In contrast, Sublocade is a controlled substance due to its opioid properties.

Injection Type

Vivitrol is an intramuscular injection, while Sublocade is a subcutaneous injection.

Injection site reactions can occur with both medications, though they are typically mild.

Effectiveness in Treating Opioid Use Disorder

Both Sublocade and Vivitrol are approved by the Food and Drug Administration (FDA) for treating opioid use disorder.

Research shows that MAT significantly improves outcomes:[5,6]

• A 2023 National Institute on Drug Abuse (NIDA) report found that buprenorphine-based medications like Sublocade reduce the risk of fatal overdose by up to 50%.
• Studies published in the American Journal of Psychiatry indicate that naltrexone (Vivitrol) is effective in preventing relapse when patients remain treatment-adherent.
  

However, treatment adherence is often higher with medications like Sublocade because they reduce withdrawal symptoms and cravings.

At Bluegrass Recovery Center, medical professionals carefully evaluate each patient’s needs to determine the most effective disorder treatment approach.

Vivitrol and Sublocade for Alcohol Dependence

One major difference between vivitrol and sublocade is their use in alcohol use disorders. Vivitrol is approved to treat alcohol dependence, while Sublocade is not used for this purpose.

Vivitrol helps reduce cravings for alcohol and supports abstinence in individuals with alcohol dependence.

This makes Vivitrol a strong option for individuals with both opioid addiction and alcohol use disorders.

Side Effects and Safety Considerations

Both medications are generally safe when administered by a qualified medical professional. However, side effects can occur.

Common Side Effects

The common side effects of Vivitrol include:[7]

• Injection site reactions
• Nausea
• Headache
• Fatigue

Sublocade can cause the following common side effects:[8]

• Injection site reactions
• Constipation
• Nausea
• Drowsiness

Serious Risks

The serious side effects of these medications include:

• Allergic reactions are possible with both medications
• Vivitrol may increase overdose risk if opioids are used after stopping treatment
• Sublocade carries risks associated with opioid medications
  

Patients should always disclose their full medical history before beginning treatment.

At Bluegrass Recovery Center, safety is a priority. Each treatment plan is closely monitored to reduce the risk of serious harm.

Choosing Between Sublocade vs Vivitrol

Deciding between Sublocade vs. Vivitrol depends on several factors.

You should consider Sublocade if:

• You want help managing opioid withdrawal symptoms
• You have difficulty maintaining abstinence during early recovery
• You prefer a medication that reduces cravings

Consider taking Vivitrol if:

• You are already opioid free
• You want a non-opioid medication
• You also need to treat alcohol dependence

Insurance and Accessibility

Health insurance and insurance plans may influence your options. Both medications are typically covered by many insurance providers, but coverage varies.

Bluegrass Recovery Center works with patients to verify insurance plans and ensure access to appropriate addiction treatment.

The Role of MAT in Long-Term Recovery

Medication-assisted treatment is not a cure for opioid addiction. Instead, it is a tool that supports a broader recovery journey.

Effective treatment includes:

• Counseling
• Behavioral therapy
• Mental health support
• Relapse prevention strategies
  

According to SAMHSA, individuals who participate in comprehensive MAT programs are more likely to maintain abstinence and achieve lasting recovery.[2]

At Bluegrass Recovery Center, MAT is integrated into a full continuum of care designed to support both physical dependence and mental health.

Preventing Relapse and Maintaining Progress

Both Sublocade and Vivitrol play an important role in preventing relapse.

They help:

• Manage cravings
• Stabilize brain chemistry
• Reduce the risk of returning to opioid drugs
  

However, long-term success depends on continued engagement in treatment and support systems.

Patients are encouraged to work closely with a medical professional to adjust their treatment plan as needed.

Get Connected to MAT for Opioid Use Disorder 

When comparing Vivitrol vs. Sublocade, there is no one-size-fits-all answer. Sublocade is often better for individuals early in recovery who need help reducing withdrawal symptoms and cravings. Vivitrol may be ideal for those who are already opioid free and want a non-opioid option.

Both medications are effective tools for treating OUD and supporting a substance-free life.

At Bluegrass Recovery Center, we understand that every recovery journey is unique. Our team provides personalized care, helping individuals choose between sublocade and vivitrol based on their specific needs, medical history, and treatment goals.

If you or a loved one is struggling with opioid addiction, reaching out for professional support is a critical first step. With the right combination of medications, therapy, and support, lasting recovery is possible. Contact Bluegrass Recovery Center today for more information on our MAT program. 

Frequently Asked Questions (FAQs)

1. How long do Vivitrol and Sublocade stay in your system?

Both medications are designed as a monthly injection, but they remain active in the body beyond 30 days. Vivitrol (naltrexone) typically blocks opioid receptors for about 28 days, though trace amounts may stay in the system longer. Sublocade (buprenorphine) forms a depot under the skin, releasing medication gradually, which can remain detectable for several weeks after the last dose. This extended action supports consistent medication levels and reduces the need for daily dosing.

2. Can you switch between Sublocade and Vivitrol?

Yes, but switching requires careful planning with a medical professional. Transitioning from Sublocade to Vivitrol involves a waiting period to ensure the body is fully opioid free, which helps prevent precipitated withdrawal. Moving from Vivitrol to Sublocade may require reintroduction to buprenorphine. At Bluegrass Recovery Center, providers create a structured treatment plan to ensure safe and effective transitions between medications.

3. What happens if you miss a monthly injection?

Missing a dose can increase the risk of cravings and relapse. For Sublocade, delayed doses may lower medication levels, potentially leading to withdrawal symptoms. For Vivitrol, missing an injection removes the opioid-blocking effect, which can increase sensitivity to opioids and raise overdose risk. Patients should contact their provider as soon as possible to reschedule and maintain treatment adherence.

4. Are these medications safe during pregnancy?

Sublocade and other buprenorphine-based medications are sometimes used during pregnancy under close medical supervision, as they can help stabilize opioid dependence and reduce harm. Vivitrol is generally not recommended during pregnancy due to limited research on safety. Treatment decisions should always be made in consultation with a qualified medical professional who can evaluate risks and benefits based on individual circumstances.

5. Do Vivitrol or Sublocade interact with other medications?

Both medications can interact with other medications, including sedatives, benzodiazepines, and certain mental health prescriptions. These interactions may increase the risk of side effects or reduce effectiveness. It is important to provide a full medical history and list of current medications before beginning treatment at Bluegrass Recovery Center or any addiction treatment provider.

6. Will I need to stay on medication-assisted treatment long term?

The length of time in medication-assisted treatment varies. Some individuals benefit from long-term use to maintain abstinence and prevent relapse, while others may taper off under medical supervision. There is no fixed timeline. At Bluegrass Recovery Center, treatment duration is based on progress, stability, and individual recovery goals, with a focus on achieving a sustainable, substance-free life.

References:

1. The Substance Abuse and Mental Health Services Administration (SAMHSA): Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health
2. SAMHSA: Substance Use Disorder Treatment Options
3. Wiley Online Library: Extended-release injectable naltrexone for opioid use disorder: a systematic review
4. The National Library of Medicine (NLM): Clinical Review Report: Buprenorphine extended-release injection (Sublocade)
5. The National Institutes of Health (NIH): Methadone and buprenorphine reduce risk of death after opioid overdose
6. Science Direct: Naltrexone treatment for opioid dependence: Does its effectiveness depend on testing the blockade?
7. The National Library of Medicine (NLM): Chapter 5—Extended-Release Injectable Naltrexone
8. Medline: Buprenorphine injection