Vivitrol vs. Sublocade: Which One Is Right For Me?

Medication-assisted treatment (MAT) has become a life-changing part of recovery for many people battling opioid addiction. By combining medication with counseling and further support, MAT can reduce cravings, prevent relapse, and make long-term recovery more achievable.

Two of the most commonly used medications in MAT today are Vivitrol and Sublocade. While both are effective, they work very differently, and choosing the right one can have a big impact on your recovery journey.

In this article, we’ll break down Vivitrol vs. Sublocade, explain how each one works as an opioid use disorder treatment, and help you understand the key difference between Vivitrol and Sublocade.

Whether you’re just starting recovery from drug abuse or looking for a new treatment plan, this guide will help you make an informed decision that fits your needs.

What Is Vivitrol?

Vivitrol is used in medication-assisted treatment (MAT) to help people in recovery from opioid or alcohol dependence. It’s the brand name for an extended-release form of naltrexone, delivered as a once-monthly injection into the muscle.

So, how does it work for substance abuse?

Vivitrol contains naltrexone which is an opioid antagonist, which means it blocks opioid receptors in the brain. This prevents any opioid you take from producing a high, which helps reduce cravings and lowers the risk of relapse. It doesn’t activate the receptors—it just keeps other opioids from attaching to them.

One important thing to know: you need to be fully detoxed from opioids—usually for 7 to 10 days—before starting Vivitrol. If opioids are still in your system, taking Vivitrol can trigger immediate and intense withdrawal symptoms.

Some common side effects of Vivitrol treatment for opioid cravings include:

• Injection site reactions (redness, soreness, or swelling)
• Nausea or upset stomach
• Headache
• Fatigue or sleep problems
• Mood changes in some individuals

Vivitrol is non-addictive and doesn’t create a “high,” making it a good option for people who want a medication that doesn’t involve opioids at all. 

What Is Sublocade?

Sublocade is another one of the prescription drugs used in medication-assisted treatment (MAT) for opioid abuse and addiction, and it works a bit differently than Vivitrol.

Sublocade is the extended-release version of buprenorphine, delivered as a once-monthly injection just under the skin (subcutaneous) rather than an intramuscular injection.

Buprenorphine works as a partial opioid agonist, meaning it activates the brain’s opioid receptors, but only partially. This helps to reduce withdrawal symptoms and cravings without producing the full “high” that other opioids do. It provides enough stimulation to ease discomfort, but not enough to create a euphoric effect when taken as prescribed.

To start Sublocade, patients first need to be stabilized on a daily buprenorphine product like Suboxone (usually for 7 days). Once stabilized, the medication is transitioned to the long-acting injection.

Common side effects may include:

• Injection site reactions (pain, itching, or swelling)
• Nausea or constipation
• Headache or dizziness
• Sleep problems or fatigue
• Mild withdrawal symptoms in some cases during the transition phase

Sublocade offers the benefit of steady, continuous medication. There is no need for daily dosing, which can help reduce the risk of misuse and increase treatment compliance.

Vivitrol vs. Sublocade: Key Differences

When choosing between these two medications, it’s important to understand the difference between Vivitrol and Sublocade. 

While both are effective tools in opioid addiction recovery, they work in very different ways and are better suited to different needs. Whether you’re starting Sublocade or Vivitrol treatment, you want to understand both.

Medication Type

• Vivitrol is an opioid antagonist, meaning it completely blocks opioid receptors without activating them
• Sublocade is a partial opioid agonist, meaning it partially activates opioid receptors to reduce cravings

Detox Requirement

• Vivitrol requires full detox (7–10 days opioid-free) before starting
• Sublocade can be started after 7 days of Suboxone, without needing full detox

Mechanism of Action

• Vivitrol blocks the effects of any opioids you might take but with no high and no reinforcement
• Sublocade mimics opioids at a low level to ease cravings

Best Suited For

• Vivitrol is best for individuals who are opioid-free and want a non-opioid, once-a-month option. It can also be used to treat people with alcohol use disorder.
• Sublocade is best for people who have already been taking an oral form of buprenorphine, such as Suboxone, for at least seven days. Unlike Vivitrol, Sublocade is only used to treat opioid use disorder.

Pros and Cons of Each Option

Both Vivitrol and Sublocade offer real benefits in opioid addiction recovery, but depending on your situation, one might be a better fit than the other. Here’s a quick look at the pros and potential drawbacks of each:

Vivitrol – Pros

• Non-addictive and opioid-free
• Only one injection per month
• No risk of physical dependence
• Ideal for people who are fully detoxed and motivated to stay opioid-free

Vivitrol – Cons

• Requires 7–10 days of complete detox before starting
• It may be less helpful for individuals still experiencing strong cravings or withdrawal
• Can cause intense withdrawal if opioids are still in the system
• Some people report side effects like fatigue, nausea, or mood changes

Sublocade – Pros

• Helps with both cravings and withdrawal symptoms
• Doesn’t require full detox—can transition from daily Suboxone
• Steady medication delivery without daily dosing
• May improve treatment retention for those in early recovery

Sublocade – Cons

• It is a form of buprenorphine, which is still a partial opioid
• Some individuals may experience minor withdrawal when switching from Suboxone
• Must be administered by a licensed provider
• Side effects may include nausea, constipation, or site irritation

How to Choose: Which One Is Right for Me?

There’s no one-size-fits-all answer when it comes to Sublocade vs. Vivitrol. The right choice depends on where you are in your recovery and what your body and brain need right now. Here are a few things to consider:

• Where are you in the opioid detox process? If you’re already opioid-free, Vivitrol might be a great fit. If you’re still managing withdrawal or on Suboxone, Sublocade could be easier to transition into.
• Have you used either before? Your past experience with Suboxone or Vivitrol (positive or negative) can help guide your decision.
• What’s your biggest challenge right now, cravings or relapse risk? If cravings are still intense, Sublocade may help more in the short term. If you’re feeling stable but want long-term relapse protection, Vivitrol might be the way to go.
• What does your medical professional or treatment provider recommend? A medical provider can assess your health history, current symptoms, and risk factors to make the safest and most effective recommendation.

No matter which medication you choose, it’s important to remember: MAT works best when it’s part of a bigger recovery plan that includes therapy, peer support, healthy routines, and continued care.

Support at New Jersey Addiction Interventions

Choosing between starting Vivitrol treatment or Sublocade is a big decision, but you don’t have to make it alone. At New Jersey Addiction Interventions, we’re here to help you explore your options and find the treatment that fits your unique recovery journey.

Contact New Jersey Addiction Interventions today to schedule an evaluation, ask questions, or learn more about MAT and long-term recovery options. You don’t have to do this alone—and with the right tools, recovery is absolutely possible.

Frequently Asked Questions About Sublocade and Vivitrol

Can I switch from Sublocade to Vivitrol (or vice versa)?

Yes, it’s possible to switch between the two, but it needs to be done under medical supervision. You’ll typically need to go through a detox period if transitioning from Sublocade (which contains buprenorphine) to Vivitrol, since Vivitrol requires your system to be opioid-free. Your provider will help guide you through the safest timeline based on your individual needs.

How long should I stay on Vivitrol or Sublocade for addiction treatment?

There’s no fixed timeline. It depends on your progress, recovery goals, and how well you’re responding to the medication. Many people stay on Vivitrol or Sublocade for several months to a year or more. The decision to taper off should always be made with your treatment team.

Is one more effective than the other for opioid use disorder?

Both medications are effective, but they work differently. Sublocade is often better at reducing cravings and withdrawal symptoms, while Vivitrol is more focused on blocking opioids to prevent relapse. The best option depends on your personal recovery stage, health history, and comfort level with each medication.

Will I still need therapy if I’m on MAT?

Yes. medication-assisted treatment (MAT) works best when combined with therapy, counseling, and peer support. The medication can help with cravings and physical stability, but therapy addresses the root causes of addiction, emotional healing, and relapse prevention.

Does insurance cover Vivitrol and Sublocade?

Most health insurance plans, including Medicaid and many private insurers, do cover both medications, especially when prescribed as part of a comprehensive MAT program. Our team at New Jersey Addiction Interventions can help you verify coverage and navigate the paperwork.