Study: 2 most common medication-assisted opioid addiction treatments produce similar results

Two primary medications used to treat opioid addiction — Vivitrol and Suboxone — are comparable in both efficacy and safety, according to a study published in The Lancet.

The study, funded by the National Institute on Drug Abuse of the National Institutes of Health, sought to identify potential treatment differences between the drugs.

Here are five things to know about the treatments and study.

1. Vivitrol contains the opioid antagonist naltrexone and is administered intravenously on a monthly basis to block the effect of opioids. Suboxone, which contains a buprenorphine-naloxone mix, is a dissolvable mouth strip taken daily to minimize withdrawals and curb cravings. Both medications are underutilized and can be prescribed by primary care physicians, according The New York Times.

2. From Jan. 30, 2014, through May 25, 2016, researchers randomly assigned one of the two medications to 570 adults with opioid addiction. Researchers monitored participants for 24 weeks after assigning the medications. Fifty-two percent of the Vivitrol group and 56 percent of the Suboxone group experienced a relapse over the 24-week period.

3. Researchers did identify a barrier to treatment with Vivitrol — the drug requires patients to detox prior to starting treatment. More than 25 percent of participants in the Vivitrol group dropped out of the study before taking the drug, while 6 percent of the Suboxone group dropped out before starting treatment. However, this finding was not the key takeaway from the study as the difficulties of detoxing are well documented, according to the study authors.

"The main finding in my view is the relatively equivalent safety and effectiveness of these two medications," John Rotrosen, MD, a psychiatry professor at New York University School of Medicine and the study's lead investigator, told the Times.

4. While Suboxone, which is manufactured by Indivior, is cheaper and more widely used, Vivitrol has earned the endorsement of many law enforcement members, as it is the only medication-assisted treatment for opioid addiction that does not contain an opioid and is less likely to be diverted than Suboxone, according to the Times.

5. Nora Volkow, MD, director of the NIDA, told the Times she hoped the study would dispel misperceptions associated with Vivitrol pertaining to patients' tolerance of the medication and the drug's ability to treat severe addiction. Dr. Volkow said the next step for addiction treatment is to improve the detox process and develop a method to determine which medication is appropriate for each individual patient.

"What patient characteristics can lead me as a physician to determine that this particular individual will do better on one of these medications than the other?" Dr. Volkow told the Times. "We have it for every other area of medicine, but not for the treatment of opioid use disorders."

More articles on opioids: 
AHIMA: 7 aspects to high-quality opioid addiction documentation in patient charts 
Salt Lake County to sue drugmakers over opioid epidemic 
GAO: CMS failed to identify thousands of Medicare beneficiaries at risk for opioid addiction

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