Is Vivitrol Safe and Effective for Alcohol and Opioid Dependence Treatment?

Man suffers from alcohol and opioid dependence and contemplates using Vivitrol.

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Vivitrol is a brand name for the drug naltrexone. It was initially approved by the Food and Drug Administration (FDA) for the treatment of alcohol dependence. It has also since been approved to treat opioid addictions.

It can be used to help people maintain abstinence during their recovery from alcohol or opioid dependence. It reduces cravings and may increase the likelihood that an individual is successfully able to stop using these substances.

How Vivitrol Works

Vivitrol is a non-addictive opioid antagonist. In other words, it blocks the effects of opioids, such as heroin, morphine, and oxycodone. It also blocks the effects of alcohol on the brain.

Individuals must completely detox from opioids for 7 to 10 days before starting Vivitrol. Otherwise, the medication could elicit serious withdrawal symptoms.

How Vivitrol Is Administered

Vivitrol is administered as a shot that is given once a month making it an attractive option for individuals who don’t want to use Suboxone or methadone— both of which are highly regulated and may require someone to visit a clinic on a daily basis.

Like all forms of naltrexone, Vivitrol works by stopping the euphoric and sedative effects of opioids. When an individual taking any form of naltrexone relapses, they won’t be able to get high or intoxicated because the drug won’t bind to the opioid receptors in their brain.

It can also work well to reduce the cravings for alcohol. Unlike treatments such as disulfiram, which discourages continued drinking by making those in recovery sick if they consume alcohol, Vivitrol discourages people from wanting to drink in the first place.

Vivitrol can help people who are working on managing their addiction to alcohol or opioids because it reduces cravings. It also does not cause feelings of euphoria, so there is no associated intoxication or abuse liability.

If an individual taking Vivitrol drinks alcohol or uses an opioid, they won’t get intoxicated or high. This makes alcohol and drugs less alluring so that over time the brain stops craving them.

How Vivitrol Is Different

The fact that Vivitrol can be given via a monthly injection makes it an attractive option for anyone who may be likely to miss doses of their medication. (There are other forms of naltrexone that are taken in pill form but must be taken every day.)

Studies consistently show that Suboxone and methadone are effective treatments for opioid dependence but they also require daily doses.

One potential downside of Vivitrol is that it requires individuals to have detoxed prior to starting treatment. People who start using Suboxone and methadone are able to get treatment even if they have still been using which could prevent painful withdrawal symptoms.

Research Studies

In a six-month double-blind study, individuals who were treated with Vivitrol and psychotherapy for alcohol use disorder experienced a 25% greater reduction in the number of heavy drinking days.

The study concluded that individuals who were treated for an alcohol use disorder spent more time abstinent and had lower rates of relapse when they were treated with both Vivitrol and psychotherapy.

In another study that examined Vivitrol’s effectiveness in treating alcohol and opioid dependence, researchers found that some patients relapsed once they stopped taking Vivitrol. But the vast majority remained abstinent.

Most patients also reported that their cravings and urges never returned to their original levels. Many reported their urges remained below the clinically significant threshold. In addition, saliva drug tests were more likely to come back negative as further evidence that patients were able to maintain their sobriety.

Another study examined the effectiveness of Vivitrol on prison inmates that were being released back into the community. Twenty-seven inmates who had opioid disorders during the prior year were recruited to receive an injection once a month.

Results indicated those completing at least six or more months of treatment were less likely to test positive for opioids when compared to other inmates who were released without treatment. Individuals who dropped out of treatment were more likely to be re-arrested compared to those who continued with monthly injections for six months.

The authors of the study stated that Vivitrol may be effective in reducing relapse rates when inmates are released, and therefore it may reduce the chances that these individuals will go back to jail.

Controversy

While some people have touted Vivitrol as a helpful cure for substance abuse, others have expressed concerns that it isn’t as useful as the drug company wants people to believe.

The drug company is accused of falsely presenting Vivitrol as a cure for the opioid crisis. And some have said the FDA approved it too quickly.

Major Concerns

One major concern involves the potential risks surrounding opioid dependence once someone stops using Vivitrol. After going for a long period without using opioids, someone with a substance abuse issue will have a low tolerance. This places them at a greater risk for overdose if they relapse.

Another major concern is the possibility of individuals trying to overcome the blocking effects of Vivitrol by taking even larger amounts of opioids than they previously did. In these cases, an overdose could lead to serious injury, coma, or death.

The company has also been accused of misleading advertisements. For example, they ran ads on New York City subways that said, “Vivitrol is the first and only non-addictive, once-monthly treatment for opioid dependence.” This implies that methadone and Suboxone are addictive treatments.

There is sometimes a stigma against methadone and Suboxone. And some people in the treatment industry feel as though Vivitrol tries to imply that individuals who use either methadone or Suboxone aren’t yet “drug-free” but that they will be if they use Vivitrol.

While some argue that replacing opioids with Suboxone or methadone is trading one addiction for another, others point out that taking regular medicine every day doesn’t constitute addiction since it doesn’t involve “compulsive drug use despite harm.”

Alkermes, the company that manufactures Vivitrol, has also been accused of aggressively lobbying legislators and criminal justice officials. They’ve donated large amounts of money to political campaigns of federal legislators and local law enforcement officers who advocate for Vivitrol and criticize methadone and Suboxone.

A Word From Verywell

If you have a problem with opioids or alcohol, talk to your physician about whether Vivitrol might be right for you. While there is some controversy around how it is marketed, it could be instrumental in reducing your cravings and curbing your substance use.

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