Changing medication-assisted treatment (MAT) medications should be approved and monitored by a trained professional, especially when switching from methadone to Vivitrol.
There are three medications approved by the U.S. Food & Drug Administration to treat opioid use disorder (OUD), which are naltrexone (Vivitrol, ReVia), methadone, and buprenorphine.
Naltrexone is the only non-narcotic MAT approved to treat OUD.
This may be a desirable option for some, however, it requires that a person is opioid-free for a number of days before starting a medication like Vivitrol.
Once Vivitrol injections have begun, the length of treatment varies. On average, Vivitrol injection treatments typically continue for 12 months.
How To Switch From Methadone To Vivitrol
When the decision is made to switch to Vivitrol from methadone, a tapering process to reduce the dosage of daily methadone may be suggested by your healthcare provider.
The length of time will vary between individuals and depending on how much methadone a person takes each day.
A person has to be free of methadone for 10 to 14 days before they can begin Vivitrol injections.
Addiction treatment professionals may consider a low dose of naltrexone in pill form during the first couple days without methadone, but this is under complete supervision and may not be an option in all areas.
Steps to switch from methadone to Vivitrol include:
- slowly reducing the amount of methadone (tapering)
- stopping methadone completely
- remaining opioid-free (including methadone) for 10 to 14 days
- working with a healthcare provider to manage methadone withdrawal
In some situations, medically supervised detox may be recommended.
Managing withdrawal symptoms can help prevent relapse or other complications during the time between stopping methadone and starting Vivitrol.
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How Much Time It Takes To Switch From Methadone To Vivitrol
Including the tapering process to lower the methadone dosage, it can take several weeks to make the transition to Vivitrol from methadone.
The process to switch depends on several factors, such as how much methadone a person takes each day, weight, and other individual differences.
Why Does It Take Weeks To Switch From Methadone To Vivitrol?
A person cannot safely take Vivitrol with any opioids in their system, including methadone.
Severe opioid withdrawal symptoms can occur if a person takes Vivitrol without waiting until all methadone is out of their system.
This intense withdrawal is called precipitated withdrawal, caused by the blocking effect that Vivitrol has on opioid receptors.
Precipitated withdrawal symptoms include:
- extreme vomiting
- severe body aches
- elevated heart rate
- intense diarrhea
- psychological issues
Possible Complications When Switching From Methadone To Vivitrol
The biggest complications that can arise when switching from methadone to Vivitrol are withdrawal symptoms and the return of opioid cravings.
Adequate medical supervision can help a person manage cravings and withdrawal symptoms that may occur while waiting to start Vivitrol injections.
Factors That Can Affect The Timeline For Switching From Methadone To Vivitrol
There are a number of factors that can alter the timeline of switching to Vivitrol from methadone, including:
- previous substance abuse
- length of time taking methadone
- available withdrawal management services
- relapse risk
- environment where tapering process is occurring
How Are Vivitrol And Methadone Different?
Vivitrol has to be injected monthly by a healthcare provider or pharmacist, methadone is usually self-administered daily after a pattern of non-abuse has been established.
Vivitrol is not shown to be addictive, but methadone can be addictive.
Insurance companies vary in their coverage of both Vivitrol and methadone, but Vivitrol tends to be significantly more expensive than methadone.
Which MAT Medication Is Better?
All three MAT medications used to treat OUD are different and have separate benefits.
Medical professionals typically work with each individual to determine which medication will work the best given their unique situation.
Locating Treatment Programs For Opioid Use Disorder
Substance abuse treatment facilities are available that can assist in the process of switching from methadone to Vivitrol or starting Vivitrol injections to treat opioid addiction.
Our addiction treatment specialists are available with information that can help you or a loved one decide if switching from methadone to Vivitrol is the right choice.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- American Society of Addiction Medicine — The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use
- CADTH Issues in Emerging Health Technologies — Injectable Extended-Release Naltrexone to Treat Opioid Use Disorder
- U.S. Food & Drug Administration — Vivitrol (naltrexone for extended-release injectable suspension) Label
- Providers Clinical Support System — Guide for Families: Medications for Opioid Use Disorder