Suboxone vs Naltrexone: Knowing What’s Right for You

Individuals who are experiencing opioid use disorder often benefit from the use of medication assisted treatment, utilizing medications such as Suboxone or naltrexone to help prevent relapse, ease withdrawal symptoms and curb cravings. Knowing the differences between Suboxone vs naltrexone is critical for those undergoing MAT regimens.

In this article, we will discuss how the two medications work, how they differ and things to consider before starting a medication assisted treatment program. 

Key Facts

• Suboxone (a partial agonist) eases withdrawal and cravings; naltrexone (an antagonist) blocks opioid effects entirely.
• Suboxone can be started while someone still has opioid dependence; naltrexone requires full detox before initiating.
• Naltrexone is also used for alcohol use disorder and comes in oral and monthly injection forms.
• The “best” medication depends on an individual’s needs, medical history and readiness for detox.
• Both are evidence based and help to reduce the risk of relapse and overdose when paired with counseling and support.

Suboxone vs Naltrexone Basics

Suboxone and naltrexone are both FDA approved medications used in the treatment of opioid use disorder (OUD). Naltrexone also has an important role in treating alcohol use disorder (AUD).

These medications aren’t meant to replace opioids or keep someone “dependent” forever; they’re tools used alongside counseling, behavioral therapies and recovery support to reduce cravings, prevent relapse and help people stay alive and stable long term.

All forms of medication assisted treatment share the same goal: give the brain and body time to heal, lower the risk of overdose and create space for real recovery to take root.

How Suboxone and Naltrexone Work in Treatment

Let’s take a look at how these medications support people with substance use disorder. 

Suboxone: Partial Agonist Support

Suboxone combines buprenorphine, a partial opioid agonist, with naloxone to discourage misuse.

Buprenorphine activates opioid receptors just enough to stop withdrawal symptoms and reduce cravings without delivering a full opioid high. For many people, this steady relief is what makes it possible for them to stop chasing the effects of a short acting opioid and begin stabilization. 

Suboxone comes in a film or tablet form that dissolves under the tongue or inside the cheek and is taken daily. A typical medication assisted treatment regimen includes induction (starting the medication once withdrawal begins), followed by stabilization and ongoing maintenance.

Many patients remain on buprenorphine for months or years because the risk of relapse is significantly lower with continued treatment.

Benefits of Suboxone use include a lower overdose risk compared with full opioids and strong protection against cravings. Risks include possible physical dependence, potential withdrawal if stopped abruptly and increased sedation when combined with alcohol or benzodiazepines. 

Naltrexone: Full Antagonist Protection

Naltrexone works differently. It’s a pure opioid antagonist, meaning it sits on opioid receptors and blocks other opioids from attaching to those sites. This prevents any opioid from producing euphoria and reduces cravings.

The biggest challenge when using naltrexone is timing. Someone must be fully opioid free for at least 7 to 10 days before starting. Otherwise, the medication can cause precipitated withdrawal, a rapid and extremely unpleasant reaction.

Naltrexone is available as a daily oral tablet or as an extended release monthly injection (Vivitrol). The injectable form is often preferred because it removes the need for daily adherence and eliminates the risk of skipping doses. Unlike Suboxone, naltrexone won’t cause physical dependence.

Although naltrexone can be an extremely important part of long term recovery, its use may present challenges for people who are experiencing chronic pain or require pain management after surgery or injury. Because it blocks opioid medications, it can limit good pain control in these situations.

Liver health is another consideration, as naltrexone is metabolized and cleared by the liver; it is not appropriate for people with liver disease or impaired liver function. 

Suboxone vs Naltrexone: Which Medication Is Right for You?

Talking with your doctor about your specific needs is essential to finding the right medicine. Understanding the difference between naltrexone and Suboxone can help you have a more productive conversation at your next appointment.

Suboxone (Partial Agonist): What to Expect

Suboxone is often recommended for people still actively dependent on opioids or those at high risk of early relapse. It’s especially helpful when completing a full detox isn’t realistic or when withdrawal symptoms have derailed previous attempts to stop using.

Other reasons Suboxone may be ideal include:

• A need for flexible, office based care
• Pregnancy
• Co use of substances that make total abstinence hard in the short term
• Comfort with daily medication management

Factors That May Favor Naltrexone vs Vivitrol

Naltrexone may be a better option for people who have already completed detox or want a fully opioid free treatment option. Monthly injections can also be appealing for those who struggle with daily adherence or want to avoid medications with misuse potential.

Naltrexone is also useful for:

• Individuals with co occurring alcohol use disorder
• Those who are uncomfortable taking an opioid agonist
• People with legal, workplace or licensure restrictions involving controlled substances
• Those who have previously misused Suboxone or other prescribed opioids

Use the Rehab.com directory to explore treatment centers that offer medications like Suboxone and naltrexone. You can also filter results by location, insurance coverage, level of care or specialized programs.

Not sure where to start? Call 800-985-8516 ( Sponsored Helpline ) today to talk to someone about treatment options and check whether insurance benefits can help cover the cost of rehab.