The shot for opioid addiction has become a powerful tool in recovery, offering long-acting medication without daily pills. If you or someone you care about is considering this treatment, understanding your options can help you make the right choice for lasting recovery.
Key takeaway:
Injectable medications for opioid addiction, including extended-release naltrexone (Vivitrol) and buprenorphine (Sublocade, Brixadi), provide month-long or weekly protection against cravings and relapse. These shots eliminate daily dosing, improve treatment adherence, and work best when combined with counseling and support.
What Is the Shot for Opioid Addiction?
When people talk about “the shot” for opioid addiction, they’re usually referring to one of two types of long-acting injectable medications. Both help manage opioid use disorder, but they work in different ways.
Extended-release naltrexone (Vivitrol) is a monthly injection that blocks opioid receptors in your brain. It prevents opioids from creating the euphoric high, which helps eliminate cravings and reduces the risk of relapse. Since it’s a full blocker, you need to be completely off opioids for 7-10 days before starting it.
Extended-release buprenorphine (Sublocade or Brixadi) is a weekly or monthly injection that works differently. It’s a partial opioid agonist, meaning it activates receptors just enough to prevent withdrawal and cravings without producing a high. You don’t need to detox completely before starting, but you do need to be stable on oral buprenorphine first.
Both medications offer a major advantage over daily pills. You get consistent medication levels without having to remember daily doses or worry about misplacing pills.
How These Shots Work in Your Body
Naltrexone injections deliver a steady dose of medication that blocks all opioid effects for about 30 days. If someone tries to use opioids while on naltrexone, they won’t feel the usual high. This blocking action continues throughout the month, providing constant protection.
The medication doesn’t create dependence, and you won’t experience withdrawal symptoms when you stop. It’s designed for people who’ve already completed detox and want strong protection against relapse, according to SAMHSA guidelines.
Buprenorphine injections release medication slowly under your skin, maintaining stable levels that suppress withdrawal symptoms and cravings. The medication partially activates opioid receptors, but there’s a ceiling effect. This means even if someone takes more, they won’t get increasingly high, making it much safer than full opioid agonists.
Studies show that people on long-acting buprenorphine have lower rates of opioid use and reduced risk of overdose. The longer someone stays on the injections, the better their outcomes tend to be.
Comparing Your Injection Options
| Feature | Naltrexone (Vivitrol) | Buprenorphine (Sublocade/Brixadi) |
|---|---|---|
| How it works | Blocks opioid receptors completely | Partially activates receptors at safe level |
| Opioid-free period required | Yes, 7-10+ days off all opioids | No, but need oral buprenorphine stabilization first |
| Dosing schedule | Monthly injection in muscle | Weekly or monthly injection under skin |
| Main benefits | Strong blockade, no addiction potential | Reduces cravings and withdrawal, prevents overdose |
| Best for | People who’ve completed detox and want abstinence-based recovery | People needing medication support without full detox |
| Limitations | Difficult induction period, no pain relief | Still an opioid, requires special provider certification |
Who Should Consider the Shot
The injection approach works well for many people, but it’s not right for everyone. You might be a good candidate if you struggle with taking daily medication, have concerns about pill diversion or misuse, want consistent medication levels without daily reminders, or you’ve tried other treatments without success.
Naltrexone might be your better option if:
- You’ve successfully completed detox
- You want complete opioid abstinence
- You don’t need opioid pain medication
- You’re committed to the opioid-free waiting period
Buprenorphine might work better if:
- You’re currently on oral buprenorphine and doing well
- You want to reduce clinic visits
- You’ve had trouble with daily medication adherence
- You’re not ready for full detox but want recovery support
Some people shouldn’t use these medications. Naltrexone isn’t safe if you’re still using opioids or need opioid pain medication. Buprenorphine injections require you to start with oral buprenorphine first, so if you can’t tolerate that, the injection won’t work either.
Benefits of Long-Acting Injections
No daily decisions. Once you get your shot, you’re protected for weeks without thinking about it. This removes the daily burden of remembering pills and eliminates the temptation to skip doses.
Better adherence. Research shows people stay on long-acting injections longer than daily medications. When you only have to show up once a month or once a week instead of every day, it’s easier to stick with treatment.
Reduced overdose risk. Both medications protect against overdose in different ways. Naltrexone blocks opioids from working, while buprenorphine satisfies receptors safely. Studies have found that people on long-acting buprenorphine have significantly lower overdose death rates.
Improved quality of life. When you’re not managing daily cravings or withdrawal, you can focus on rebuilding your life. People report better employment, housing stability, and relationships while on these medications.
Less stigma. Taking an injection once a month is more private than daily clinic visits or carrying medication bottles. This privacy can reduce the shame that sometimes comes with treatment.
What to Expect When Starting Treatment
Starting naltrexone requires careful planning. You need to be off all opioids for at least 7-10 days, which can be challenging. Some treatment centers now offer rapid induction protocols that get you started in 5-7 days with close medical supervision, though this requires more intensive support.
Starting buprenorphine injections is usually smoother. Your doctor will stabilize you on oral buprenorphine first, typically for at least a week. Once you’re stable, they’ll give you your first injection. Some people continue oral medication for a few days as the injection begins working.
Both medications require administration by a healthcare provider. You can’t take these shots home. Naltrexone is given as an intramuscular injection in your buttocks. Extended-release buprenorphine is injected under the skin. Sublocade is administered only in the abdominal area, while Brixadi can be injected in the abdomen, thigh, or upper arm.
Side effects are generally mild. Naltrexone may cause injection site reactions, nausea, headache, or fatigue. Buprenorphine injections can create lumps or itching at the injection site that usually resolve on their own.
Finding the Right Treatment Program
Not every treatment center offers injectable medications for opioid addiction. When you’re looking for care, ask specifically about their experience with Vivitrol, Sublocade, or Brixadi.
Look for programs that provide comprehensive support beyond just the medication. The shots work best as part of a comprehensive opioid treatment program that includes counseling, peer support, and help addressing life challenges like housing, employment, or dual diagnosis treatment for mental health concerns.
Check whether the program accepts your insurance. Most major insurance plans cover these medications, but coverage details vary. Treatment centers can verify your benefits before you start.
Ask about the program’s approach to choosing between medications. Good programs will discuss both options with you, explain the differences, and help you decide which makes sense for your situation. They won’t push one over the other without considering your needs.
Making Your Decision
Choosing medication treatment for opioid addiction is a personal decision. Some people prefer the complete opioid blockade that naltrexone provides. Others do better with the gentler approach of buprenorphine.
Your history matters. If you’ve tried to detox multiple times without success, buprenorphine might be a better starting point. If you’ve completed detox and want strong protection against relapse, naltrexone could be the right choice.
Your life circumstances matter too. If you have chronic pain that requires opioid medication, naltrexone isn’t an option. If you have liver problems, your doctor needs to monitor you more closely on naltrexone.
The best choice is the one you’ll stick with. Recovery doesn’t happen overnight. These medications work because they give you time and space to rebuild your life without fighting constant cravings.
Frequently Asked Questions
How long do I need to stay on the shot?
There’s no set timeframe. Some people use injectable medications for a few months, others for years. Research shows that longer treatment usually leads to better outcomes. Work with your treatment team to decide what’s right for you based on your stability and goals.
Will I feel high or sedated from the shot?
No. Naltrexone creates no euphoria at all since it blocks opioid effects. Buprenorphine is designed to prevent highs while keeping you comfortable. Most people feel normal and stable, not high or sedated.
What happens if I relapse while on the shot?
If you’re on naltrexone and use opioids, you won’t feel effects and risk overdosing by using more to overcome the blockade. If you’re on buprenorphine and use opioids, the buprenorphine’s blocking effect may prevent you from getting high, and you’re at lower overdose risk. Either way, tell your treatment team immediately so they can provide support.
Does insurance cover these medications?
Most major insurance plans cover both naltrexone and buprenorphine injections when medically necessary. Coverage varies by plan, so check your specific benefits. Many treatment centers will verify your coverage before you start.
Can I take pain medication while on the shot?
Naltrexone blocks all opioid medications, including those for pain, so it’s not suitable if you need opioid pain relief. Buprenorphine provides some pain relief itself, but talk to your doctor about managing pain while in treatment.
What’s the difference between Sublocade and Brixadi?
Both are extended-release buprenorphine injections. Sublocade is typically given monthly, while Brixadi offers both weekly and monthly dosing options. Your doctor can help you decide which schedule works better for your needs.
Do I still need therapy and counseling?
Yes. Medication addresses the physical aspects of addiction, but counseling helps you understand triggers, build coping skills, repair relationships, and create a life that supports recovery. The combination of medication and therapy produces the best outcomes.
Key Takeaways
Long-acting injectable medications for opioid addiction offer powerful support for recovery. Naltrexone (Vivitrol) completely blocks opioid effects and works best for people who’ve completed detox. Buprenorphine (Sublocade, Brixadi) provides gentler support without requiring full detox first.
Both options eliminate daily medication decisions and improve treatment adherence. They work best as part of a comprehensive treatment plan that includes counseling and peer support. Insurance typically covers these medications when medically necessary.
The right choice depends on your personal history, current situation, and recovery goals. Talk with addiction medicine specialists who can help you understand which option makes sense for you.
Recovery is possible. These medications give you the breathing room you need to rebuild your life while your brain heals from opioid dependence.
Ready to explore your options for opioid addiction treatment? Vanguard Behavioral Health offers comprehensive medication-assisted treatment with both naltrexone and buprenorphine injections. Our experienced team will help you determine which approach fits your recovery goals. Contact us today to schedule a confidential assessment and take the first step toward lasting recovery.
