Choosing the right medication for recovery can shape how smoothly your journey moves forward. Naltrexone and Suboxone both help treat opioid addiction, but they work in different ways and fit different stages of recovery.
If you’ve already completed detox, Naltrexone helps prevent relapse by blocking opioid effects, while Suboxone eases withdrawal symptoms and supports early recovery.
Understanding how each medication works helps you make a more confident decision with your healthcare provider. Both options can reduce cravings and lower relapse risk, but factors like timing, medical history, and treatment goals determine which one suits you best.
At Fusion Recovery Center, you can explore how these medications fit into a complete recovery plan that includes counseling, support, and long-term care.
Key Takeaways
- Naltrexone and Suboxone help treat opioid dependence in different recovery stages.
- The right choice depends on detox status, health needs, and treatment goals.
- Combining medication with therapy and support improves long-term success.
Naltrexone vs Suboxone: Key Differences and Similarities
Both naltrexone and Suboxone help treat opioid use disorder but act in different ways. Naltrexone blocks opioid effects entirely, while Suboxone reduces cravings and withdrawal symptoms.
Understanding how these medications work, when they are prescribed, and their potential for misuse helps you and your provider choose the best option for your recovery plan.
Mechanisms of Action
Naltrexone is an opioid antagonist, meaning it blocks opioid receptors in the brain. It prevents opioids from producing euphoria or pain relief.
Because of this, you must be fully detoxed before starting naltrexone to avoid sudden withdrawal. It is available as a daily pill or a monthly injection known as Vivitrol.
Suboxone combines buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that activates opioid receptors just enough to reduce cravings and withdrawal without creating a strong high.
Naloxone, an opioid antagonist, discourages misuse by blocking opioid effects if the drug is injected.
| Medication | Type | Main Components | How It Works |
| Naltrexone | Opioid antagonist | Naltrexone | Blocks opioid receptors and prevents opioid effects |
| Suboxone | Partial agonist + antagonist | Buprenorphine + Naloxone | Reduces cravings and withdrawal while limiting misuse |
Treatment Objectives and Indications
You typically use naltrexone after completing detox. It helps maintain sobriety by blocking opioid effects and reducing relapse risk.
It’s also approved for alcohol use disorder because it lowers alcohol cravings. Naltrexone suits people who are not physically dependent on opioids and want a non-opioid maintenance option.
Suboxone is often started earlier in recovery. It helps manage withdrawal symptoms during detox and supports long-term treatment.
Doctors can prescribe it in outpatient settings, making it accessible for ongoing care. Suboxone suits individuals who still have some physical dependence but need a safer, controlled medication to stabilize recovery.
Your provider will assess your health history, opioid use patterns, and treatment goals before recommending one.
Potential for Misuse and Dependence
Naltrexone has no addictive properties and does not cause physical dependence. Because it blocks opioid receptors, taking opioids while on naltrexone will not produce the desired effects.
However, using opioids after stopping naltrexone can increase overdose risk since your tolerance drops.
Suboxone, containing buprenorphine, can cause mild physical dependence with long-term use. Stopping it abruptly may lead to withdrawal symptoms.
The naloxone component helps prevent misuse by triggering withdrawal if injected or misused. When used as prescribed, Suboxone has a lower misuse potential than full opioid agonists like heroin or oxycodone.
Healthcare providers often taper doses gradually to minimize withdrawal and dependence risks. Both medications require medical supervision for safe and effective treatment.
Effectiveness in Treating Opioid Use Disorder and Alcohol Use Disorder
Both naltrexone and Suboxone (buprenorphine/naloxone) are proven tools in medication-assisted treatment (MAT). Each medication works differently to reduce cravings, lower relapse risk, and support long-term recovery from substance use disorders.
Your treatment success often depends on your medical history, goals, and response to each medication.
Opioid Use Disorder (OUD) Outcomes
Suboxone acts as a partial opioid agonist, binding to opioid receptors to reduce withdrawal symptoms and cravings without producing a strong “high.” This helps you stabilize faster and maintain daily function.
Studies show that long-term Suboxone treatment cuts the risk of overdose and improves treatment retention compared to no medication.
Naltrexone, an opioid antagonist, blocks opioid receptors completely. It prevents opioids from producing any euphoric effect, which can help you avoid relapse.
However, you must be fully detoxed before starting naltrexone to prevent withdrawal.
| Medication | Mechanism | Key Benefit | Common Challenge |
| Suboxone | Partial agonist | Reduces cravings, supports retention | Risk of misuse or diversion |
| Naltrexone | Full antagonist | Blocks opioid effects | Requires full detox before use |
Both medications can be effective, but Suboxone is often preferred for those with severe dependence due to easier initiation and better treatment adherence.
Alcohol Use Disorder (AUD) Applications
Naltrexone is also approved to treat alcohol use disorder. It works by reducing the rewarding effects of alcohol, helping you drink less or stop completely.
You can take it as a daily pill or monthly injection. Research shows that people using naltrexone often experience fewer heavy drinking days and stronger control over alcohol use.
Suboxone is not approved for alcohol use disorder. While it helps with opioid cravings, it does not affect alcohol-related brain pathways.
For individuals managing both OUD and AUD, naltrexone may be a more suitable option, as it can address both conditions under medical supervision.
Relapse Prevention and Cravings
Both medications reduce relapse risk but in different ways. Suboxone stabilizes opioid receptors, preventing withdrawal and lowering the urge to use.
This steady state helps you focus on counseling and recovery goals. Naltrexone blocks the reward system that reinforces substance use.
Over time, this can weaken the psychological link between stress and drug or alcohol cravings. Extended-release naltrexone injections offer consistent coverage for about 28 days, reducing missed doses and improving adherence.
When combined with counseling and behavioral therapy, both medications enhance long-term recovery outcomes and improve quality of life for people managing OUD or AUD.
Administration Methods and Dosage Considerations
The way you take Naltrexone or Suboxone affects how well the medication works and how easily you can stay consistent with treatment. Each option uses a different route, dosing schedule, and level of medical supervision, which can influence comfort, convenience, and long-term adherence.
Sublingual Film and Tablets
Suboxone is most often taken as a sublingual film or tablet placed under your tongue until fully dissolved. This allows the medication to absorb directly into your bloodstream, bypassing the digestive system.
You should avoid eating or drinking until the film or tablet dissolves completely. The film form offers flexible dosing and reduces the chance of misuse since it dissolves quickly and is harder to tamper with.
Some people find the tablet easier to handle, though both forms contain the same active ingredients: buprenorphine and naloxone.
Typical Suboxone doses range between 2 mg to 24 mg of buprenorphine per day, adjusted based on your withdrawal symptoms and cravings. Your provider may gradually taper the dose over time to limit dependence and reduce withdrawal discomfort.
Oral and Extended-Release Injections
Naltrexone comes in two main forms: oral tablets and extended-release injections. The oral version is taken once daily, usually at a 50 mg dose.
It blocks opioid effects but requires strict daily adherence, which can be difficult for some people during early recovery. The extended-release naltrexone injection (often known by the brand Vivitrol) is given once every four weeks by a healthcare professional.
This injection maintains steady levels of medication and removes the need for daily dosing. It is best suited for people who have already completed detox, as opioids must be fully cleared before starting treatment.
Both forms help prevent relapse by blocking opioid receptors, but the injection provides stronger protection against missed doses.
Dosing Frequency and Tapering
Suboxone is usually taken once daily, though some patients may split doses depending on how their body responds. Over time, your provider might slowly reduce the dosage to help your body adjust without triggering withdrawal.
Naltrexone, in contrast, does not require tapering since it does not cause physical dependence. However, timing is important—you must be opioid-free for 7–10 days before starting to avoid sudden withdrawal.
Comparison Table
| Medication | Typical Form | Frequency | Taper Needed | Administered By |
| Suboxone | Sublingual film/tablet | Daily | Yes | Self-administered |
| Naltrexone (oral) | Tablet | Daily | No | Self-administered |
| Naltrexone (extended-release) | Injection | Every 4 weeks | No | Healthcare provider |
Side Effects and Safety Profiles
Both Naltrexone and Suboxone can cause side effects that affect your comfort and safety during treatment. You should understand how each medication interacts with your body, what symptoms to watch for, and when to contact your healthcare provider.
Common Side Effects
You may experience mild to moderate side effects when starting either medication. Naltrexone often causes nausea, headache, fatigue, anxiety, or insomnia.
These symptoms usually improve after your body adjusts. Some people also report tiredness or mild depression.
Suboxone can lead to constipation, headaches, nausea, or sleep problems. Because it contains buprenorphine, mild opioid-like effects may occur early in treatment.
Most side effects lessen with stable dosing and hydration.
| Medication | Common Side Effects |
| Naltrexone | Nausea, headache, fatigue, anxiety, insomnia |
| Suboxone | Constipation, headache, nausea, insomnia, mild withdrawal |
If you notice persistent vomiting, severe dizziness, or mood changes, contact your provider.
Withdrawal Symptoms and Risks
Naltrexone can trigger withdrawal if opioids are still in your system. You must be fully detoxed before starting it.
Otherwise, symptoms such as sweating, cramps, vomiting, or anxiety can appear within hours. Suboxone helps reduce cravings and withdrawal during early recovery but can still cause mild withdrawal if doses are missed or stopped suddenly.
Symptoms may include insomnia, muscle aches, restlessness, and irritability. Neither drug should be mixed with opioids or alcohol.
Doing so increases the risk of opioid overdose or respiratory depression, especially if tolerance has dropped after detox. Always follow your provider’s dosing plan.
Special Considerations for Pregnancy and Liver Health
Both medications require caution if you’re pregnant or have liver problems. Naltrexone may stress the liver, especially at higher doses or when combined with alcohol or other liver‑affecting drugs.
Regular liver function tests are recommended. Suboxone is sometimes used during pregnancy, but only under medical supervision.
Buprenorphine may be safer than full opioids, yet newborns can experience neonatal withdrawal after birth. If you have hepatitis, liver disease, or elevated liver enzymes, your provider may adjust your dose or recommend an alternative.
Always report any yellowing of the skin, dark urine, or abdominal pain immediately.
Choosing the Right Medication for Your Recovery
Selecting between naltrexone and Suboxone depends on your stage of recovery, level of opioid dependence, and readiness for detox. The right option balances medical safety, personal comfort, and long-term stability while reducing the risk of relapse and withdrawal symptoms.
Factors Influencing Medication Choice
Your current stage in recovery strongly affects which medication fits best. If you have completed opioid detox and no longer have opioids in your system, naltrexone may be suitable because it blocks opioid effects and supports relapse prevention.
If you still experience cravings or mild withdrawal symptoms, Suboxone may be more effective. It contains buprenorphine to ease cravings and naloxone to prevent misuse.
Suboxone helps stabilize you early in recovery and allows gradual tapering over time. Other factors include your medical history, co-occurring mental health conditions, and risk of relapse.
Cost, insurance coverage, and convenience also play a role. For example, naltrexone is available as a daily pill or monthly injection, while Suboxone is usually taken daily under the tongue.
| Medication | Best For | Main Benefit | Form |
| Naltrexone | After detox | Blocks opioid effects | Pill or injection |
| Suboxone | During early recovery | Reduces cravings | Film or tablet |
Transitioning Between Medications
Switching between Suboxone and naltrexone requires careful medical planning. You must fully clear opioids and Suboxone from your system before starting naltrexone to avoid precipitated withdrawal.
This usually means waiting 7–10 days after your last Suboxone dose. If you move from naltrexone to Suboxone, your provider will assess your tolerance and dependence level before reintroducing an opioid-based medication.
This process helps prevent relapse and ensures your body adjusts safely.
Role of Medical Supervision and Support
You should never start or stop these medications without medical guidance. A qualified provider monitors your progress, manages side effects, and adjusts your dosage as needed.
Medical supervision also helps coordinate behavioral therapy, counseling, and support groups, which strengthen recovery outcomes. Combining medication with therapy improves commitment to treatment and reduces relapse risk.
Ongoing communication with your care team ensures that your medication plan continues to meet your needs as your recovery evolves.
Comparing Naltrexone, Suboxone, and Other MAT Options
Each medication used in medication-assisted treatment (MAT) works differently to support recovery from opioid use disorder. Understanding how these drugs act on the brain and how they fit into a broader treatment plan helps you and your provider choose the most effective option for your needs.
Methadone Versus Naltrexone and Suboxone
Methadone, naltrexone, and Suboxone all treat opioid dependence but differ in how they interact with opioid receptors.
- Methadone is a full opioid agonist, meaning it fully activates opioid receptors to prevent withdrawal and cravings.
- Suboxone contains buprenorphine, a partial agonist, which activates receptors only slightly, reducing cravings without producing a strong high.
- Naltrexone is an antagonist that blocks receptors, preventing any opioid effect.
You usually take methadone daily at a certified clinic, while Suboxone can be prescribed for home use. Naltrexone is available as a daily pill or a monthly injection.
| Medication | Type | Administration | Risk of Dependence | Common Use |
| Methadone | Full agonist | Daily clinic dose | Moderate | Long-term maintenance |
| Suboxone | Partial agonist | Daily sublingual | Low | Outpatient treatment |
| Naltrexone | Antagonist | Oral or injection | None | Relapse prevention |
Comprehensive Treatment Approaches
Medication alone rarely addresses all aspects of addiction. Effective MAT programs combine medication with behavioral therapy, counseling, and social support.
You may work with a team that includes doctors, therapists, and case managers. They help you manage triggers and build coping skills.
Therapies such as cognitive behavioral therapy (CBT) or motivational interviewing often pair well with medications like Suboxone or naltrexone. These methods help you change thought patterns linked to substance use.
Support groups and recovery coaching can also strengthen accountability.
Finding the Right Medication for Long-Term Recovery
Both Naltrexone and Suboxone play vital roles in helping individuals overcome opioid dependence, but choosing the right one depends on where you are in your recovery journey. If you’ve completed detox, Naltrexone can help maintain sobriety by blocking opioid effects and reducing relapse risk. If you’re still managing withdrawal or cravings, Suboxone may provide the stability and support you need to move forward safely.
At Fusion Recovery, our clinicians take the time to understand your unique needs, medical history, and recovery goals before tailoring a treatment plan designed for long-term success. With compassionate care, evidence-based therapies, and ongoing medical supervision, we’ll help you find the path that’s right for you.
Take the first step toward lasting recovery. Book a confidential appointment with Fusion Recovery today or call to speak with a specialist who can guide you toward a personalized treatment plan that works.
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