Although both Vivitrol and Suboxone outperform placebos, the study cited in this article pits these commonly prescribed medications against one another.
What is the focus of this research?
Opioid overdoses accounted for 33,000 overdoses in the United States in 2015. In the United States, overdose is now the leading cause of accidental death. These figures highlight the urgent need for effective treatments for opiate addiction.
Suboxone Buprenorphine is frequently prescribed in combination with the naloxone medication. Suboxone is the result of combining the two. Suboxone is an opiate agonist that works to reduce opiate use and prevent relapse in both the short and long term.
Vivitrol is an opiate antagonist made as an extended-release once-a-month injection and is another evidence-based medication for opiate use disorder. This medication is given once a month rather than every day, and it may help to alleviate concerns about the need for daily medication, as well as issues that may arise if a person is also taking non-opiate drugs, such as alcohol.
What method was used to conduct this research?
Researchers compared the effects of Vivitrol and Suboxone in this study. The authors conducted a 6-month controlled study to compare Vivitrol detox with Suboxone detox in 570 individuals (283 who got Vivitrol detox and 287 who got Suboxone detox). The study's subjects were all enrolled in one of eight in-patient opiate detox clinics throughout the United States. The main result was relapsed, with failure to start the medicine, adverse events such as overdoses, and the proportion of days taking an opioid throughout the trial as secondary outcomes.
What were the study's findings?
- Suboxone users relapsed at a rate of 57 percent. This was much lower than the 65 percent who relapsed following opiate detox in the Vivitrol group.
- Suboxone users had an average of 10 opiate-free screenings, while Vivitrol users only had an average of 4 opiate-free screens.
- Suboxone users reported 81 days without opiates, whereas Vivitrol users reported 39 days without opiates.
- The Suboxone group had a much longer period before relapsing. The Vivitrol detox group took 14 weeks, whereas the Vivitrol group took just 8 weeks.
It's worth mentioning that the benefit from Suboxone appeared early in this research - within the first six weeks. Vivitrol began to show an advantage for those who made it beyond the 6-week mark.
The difficulty of individuals getting started on Vivitrol accounts for the majority of the benefit from Suboxone, which is consistent with clinical concerns and findings. The research showed that getting started on Vivitrol was challenging — just 72 percent of individuals who were given the drug were able to start it effectively, compared to 94 percent of those who were given Suboxone.
If people began Vivitrol more than 3 days after beginning their opiate detox, they had a better probability of starting the drug effectively. For Vivitrol patients, abstinence for at least a few days made a difference in their results.
There was no difference in adverse outcomes, such as overdosing, between the two groups. Overdoses occurred in 15 individuals who were given Vivitrol, two of whom died, and eight people who were given Suboxone overdosed, three of whom died. This implies that 23 of the 570 individuals in the study overdosed, with five of them dying as a result.
The study's success rates were low, with more than half of the patients relapsing before the first six months were over. This experiment indicates that there is still a lot of space for development.
We can infer a lot of things from this research. The first is that utilizing medication-assisted treatment (MAT) to help individuals quit using opiates may be effective, with Suboxone emerging as the study's "winner." It also demonstrates that there is still more work to be done in the field of MAT. While it's wonderful that we have medicines to assist individuals to go off opiates, it's obvious that the MAT we have now isn't ideal.
Unfortunately, pharmaceutical firms profit handsomely from the medicines they presently manufacture, so there is little motivation for them to develop formulations that will yield better results. As a result, the future of MAT remains unclear until new solutions are discovered.