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Is There a Suboxone Shot?

Suboxone is a combination buprenorphine/naloxone Medication for Addiction Treatment (MAT) medication that is administered as a sublingual filmstrip.[1] The active medication in Suboxone is Buprenorphine. 

Buprenorphine also comes in an injectable form called Sublocade. When administered via injection, the Buprenorphine releases slowly in the body over the course of a month. 

Both are FDA-approved medications used in MAT for OUD.

Types of Injectable MAT: Sublocade vs Vivitrol

Sublocade 

Sublocade is a once-a-month, extended-release buprenorphine shot that can be administered to manage opioid cravings and withdrawal symptoms on a long-term basis. 

Buprenorphine is a partial opioid agonist, so it still triggers the opioid receptors in the brain, just to a lesser extent than full opioid agonists like heroin, fentanyl, or prescription painkillers. You will usually need to take sublingual buprenorphine (Suboxone) for at least a few days before starting Sublocade to make sure you don’t have any adverse reactions to buprenorphine.[2] The Sublocade shot can help to control cravings and minimize the odds of relapse.

Vivitrol

Naltrexone is another FDA-approved MAT for the treatment of OUD, and it also comes in an injectable formulation called Vivitrol.[3] 

Naltrexone is an opioid antagonist medication, so it blocks the effects of opioid drugs. In this way, Vivitrol can help to maintain treatment compliance and minimize the odds of relapse when used as part of a comprehensive opioid addiction treatment program. 

Vivitrol is administered by a health care provider once a month after opioids have fully processed out of the body. This can take between one to seven days depending on the kind of opioid used. 

The Vivitrol shot does not control cravings or manage opioid withdrawal symptoms. It merely acts as a deterrent for illicit opioid misuse by preventing the individual from “getting high” or overdosing if they do choose to use opioids. Because it does not actually help with cravings or prevent withdrawal symptoms, it may not be as effective at minimizing the odds of relapse, especially in the acute withdrawal phase. However, for patients who do not tolerate Suboxone for any reason or do not want to be on any opioid medication, Vivitrol might be an appropriate alternative.

Benefits of Injectable Sublocade Over Pills or Strips 

The benefits of a shot for MAT during OUD treatment and recovery is that it is administered under direction of a trained health care provider, so there is little chance of misuse. It can also be convenient to only get a shot once per month instead of needing to remember to take medication every day. It may also have fewer of the unpleasant side effects such as bad taste in the mouth or nausea that can be common with Suboxone.

Benefits of Pills or Strips over Injections 

The vast majority of people using Buprenorphine for OUD use pills or strips, mostly because they are less expensive and more readily available. The downsides to Sublocade is that it can be expensive and hard to get insurance to pay for. It also requires that the patient be responsible about making sure they come in every month for their injection and do not miss appointments. Lastly, it may be hard to find a pharmacy or provider that offers the injection. 

While most people do just fine with strips or tablets, Sublocade is an option for you if you think you have a special circumstance. Talk to your doctor more if you think an injectable option would be more optimal for you in your recovery.

How to Get an MAT Shot

To get a Vivitrol or Sublocade shot, you will need to talk to your health care provider to determine if it is the best option for you. You will need to be fully detoxed from other opioids. With Sublocade, you will likely be advised to take Suboxone or sublingual buprenorphine for at least a few days before getting the injection to make sure your body tolerates the medication well. 

The shot will need to be administered once per month by a health care provider. Often, it will be used during MAT as part of a complete opioid addiction treatment program. Reach out to your doctor to learn more.

Sources

  1. Suboxone. Indivior, PLC. https://www.suboxone.com/. 2022. Accessed September 2022.
  2. Sublocade. Indivior, PLC. https://www.sublocade.com/resources?utm_campaign=BR%20%7C%20PAT%20%7C%20Sublocade&utm_source=google&utm_medium=cpc&utm_term=sublocade&gclid=Cj0KCQjw08aYBhDlARIsAA_gb0eOkCozptNnh5Rj08Vpq-9aUZ6dU-bHdC9u8w4Tw4HZ6dTQI9ngar8aAqDZEALw_wcB&gclsrc=aw.ds. 2022. Accessed September 2022.
  3. Vivitrol. Alkermes, Inc. https://www.vivitrol.com/alcohol-dependence?utm_medium=cpc&utm_source=google&utm_campaign=2022+Branded&utm_term=vivitrol_exact&utm_content=Brand+-+Exact&gclsrc=aw.ds&&gclid=Cj0KCQjw08aYBhDlARIsAA_gb0e7bnppmwskNmXhw9SPqJjfTuOfs0TOTqVh8En8ihNGMtHSAUMN_JEaAl3yEALw_wcB&gclsrc=aw.ds. 2022. Accessed September 2022.
  4. Highlights of Prescribing Information Subutex. Indivior, Inc. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwj9vqr27_b5AhWIAjQIHZE0Cv0QFnoECBUQAQ&url=https%3A%2F%2Fwww.accessdata.fda.gov%2Fdrugsatfda_docs%2Flabel%2F2018%2F020732s018lbl.pdf&usg=AOvVaw3C598ZVOiWJHiI8gTEd7Je. February 2018. Accessed September 2022.
  5. Zubsolv. Orexo US, Inc. https://www.zubsolv.com/. 2022. Accessed September 2022.

Medically Reviewed By: Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.
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