Opioid Addiction Treatment Medications: Naltrexone vs. Suboxone, New Study Reports Both Effective
In the midst of the opioid overdose epidemic, a new study funded by the National Institute on Drug Abuse (NIDA) finds both Suboxone and Naltrexone equally effective in treating addiction to heroin and prescription painkillers.
An estimated 300,000 people have died since 2001 as a result of opioids, making it the leading cause of death for adults under the age of 50 in the United States.
What is the Difference Between Suboxone and Naltrexone (Vivitrol)?
Though both Suboxone and Naltrexone medications curb the desire and cravings to use heroin or other opioids, they differ in a few key ways:
Suboxone, which is buprenorphine and naltrexone, is a daily pill that is taken before a person goes through detox or continued after detox and during recovery. It’s considered a replacement medication, like methadone, because it is a partial agonist. The downside to Suboxone, though, is that it must be taken orally on a daily basis.
Vivitrol, the brand name for naltrexone, is a narcotic blocker or what’s known as an opioid antagonist. This medication, which is as effective as Suboxone, is a monthly injection. A potential downside for patients, though, is that it can only be administered after opioid withdrawal takes place.
What Are the Results of the NIDA Study on Suboxone and Naltrexone?
The three-year NIDA study, published this month in the online journal The Lancet, included 570 participants, eight out of ten whom were addicted to heroin.
Physicians administered either Naltrexone or Suboxone to the patients over a 24 month period and found some of the following:
- Opioid cravings were initially lower on naltrexone, but by the end of the 24-week test period, those on Suboxone reported a similar decrease in their cravings
- Relapse rates on both medications were not that far apart either. With naltrexone, 52 percent of participants relapsed after six months, while 56 percent taking Suboxone relapsed in the same time period
- A significant challenge for those on taking naltrexone was making it through detox so they could get the medication. According to the study, about one-quarter of participants were unable to make it through detox and receive the drug
- During the study, there were five fatal overdoses from relapse, two in the naltrexone group and three in the suboxone group
Two Choices for Breaking the Cycle of Addiction
Even with relapse rates just over 50 percent, medication assisted treatment (MAT) with Naltrexone and Suboxone is still the most effective, currently available approach to treating opioid addiction.
The lead researcher, Dr. Joshua Lee, an associate professor at New York University School of Medicine’s departments of medicines and population health, believes his study proves that both Suboxone and Naltrexone are effective in breaking the cycle of addiction.
“This gives people two choices,” Lee said in an interview with CBS News. “People shouldn’t hesitate to seek treatment with either of these medications. They can look to this study to see which one is going to fit them.”
Despite President Donald Trump’s declaring the opioid epidemic a public health emergency last month, it’s unclear how this might help public health officials and, more importantly, patients suffering from opioid addiction get greater access to these medications.
While Medicaid, Medicare and most insurers cover the cost of Suboxone and naltrexone, the drugs can cost as much as $600 to $1,200 a month for patients without health insurance.
“There needs to be more access to these medications,” Jonathan Morgenstern told CBC News. Vice-president for addiction services at Northwell Health in New Hyde Park, N.Y., Morgenstern believes patients also need counseling for motivation and relapse prevention and added, “But funding to provide that care is very limited.”
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