Buprenorphine

PRO Once a day – easy
Eliminates withdrawal rapidly
Curtails cravings
Blocks effects if other opiates are used Restores feeling ‘normal’
Balances dysregulated stress hormone systems
Enables you to recover – change your life – while protected by a forcefield
Massive research showing efficacy and safety
CON Marinating you in opiates. If you were not really dependent, you will be.
Dry mouth (bad for teeth)
Sometimes, constipation
Sometimes, at high dose, more often in me, reduced libido
Difficult to stop the last few milligrams
Can precipitate withdrawal if started too close to regular opiates
Requires some ongoing engagement with treatment
Still causes OD with high dose benzos or alcohol
Some people feel it’s not ‘clean’ (though we feel this is shallow and pejorative)

Naltrexone (Vivitrol)

PRO Once a month injection – easy
No withdrawal when you stop it
Prevents the ‘high’ from use and so extinguishes the urge
Preferred by some licensing boards
CON Low effectiveness overall
Difficult to start as it needs at least 7 days abstinence
People relapse because they stop
OD risk is much higher after using it
People with stress issues likely to have trouble tolerating it
Protracted withdrawal after starting it
Less, and limited, research