Vivitrol Treatment for Alcoholism and Addiction

Vivitrol is an extended-release formulation of naltrexone, an opioid receptor antagonist used in the treatment of alcoholism and opioid addiction. While naltrexone hydrochloride is for both daily and once-a-month dosages, Vivitrol is the once-a-month form of the medication. The U.S. Food and Drug Administration approved Vivitrol for the treatment of alcohol abuse in 2006.

How Vivitrol Works

Vivitrol works by blocking the effect that opioids have on the brain, and reduces the cravings that many people experience after they quit.

Physicians prescribe Vivitrol for patients who have already stopped drinking and using opioid drugs (such as morphine, heroin, and prescription pain medications) and who have gone through a detoxification process.

With alcohol, it is not certain how Vivitrol actually works, but it seems to change how the brain responds to alcohol consumption.

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You administer Vivitrol by intramuscular injection once a month. One of the main problems with the daily dosages of naltrexone was medication compliance; patients had to remember and be willing to take the pills each day. With the once-a-month shot, medication compliance is less of a factor in the treatment plan.

Is Vivitrol Right for You?

Patients already completely detoxed from alcohol and opioids are candidates for Vivitrol. It is not intended to help someone stop drinking.

According to the FDA, patients "must not have any opioids in their system when they start taking Vivitrol; otherwise, they may experience withdrawal symptoms from the opioids. Also, patients may be more sensitive to opioids while taking Vivitrol at the time their next scheduled dose is due. If they miss a dose or after treatment with Vivitrol has ended, patients can accidentally overdose if they restart opioid use."

Patients with acute hepatitis or liver failure should not take Vivitrol.

Vivitrol vs. Other Medications

Vivitrol is the first non-narcotic, non-addictive, extended-release medication approved for the treatment of opioid dependence. Methadone and buprenorphine, also approved for opioid addiction treatment, can be addictive. Methadone is available only through specialized clinics. Buprenorphine is available through doctors' offices, but it and methadone require daily doses.

Side Effects

According to the FDA, side effects of Vivitrol during trial studies include:

  • Dizziness
  • Headache
  • Muscle cramps
  • Nausea and vomiting
  • Painful joints
  • Tiredness

Other potentially serious side effects of Vivitrol include:

  • Allergic reactions, such as hives, rashes, facial swelling
  • Feeling depressed
  • Liver damage
  • Pneumonia
  • Reactions at the injection site, which can be severe and may require surgical intervention
  • Suicide, suicidal thoughts, and suicidal behavior

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Alkermes, the drug's manufacturer, claims the main side effects are:

  • Increased liver enzymes
  • Inflammation of nasal passages
  • Insomnia


Vivitrol works best in conjunction with an overall treatment program. Research shows it is more effective than medications requiring a daily dose and double-blind, placebo-controlled clinical trials show Vivitrol effectively prevents relapse and reduces drug cravings. 

FDA trials found Vivitrol patients are more likely to stay in treatment and to refrain from using illicit drugs and 36 percent were able to stay in treatment for the full six months without using drugs, compared with 23 percent in the placebo group.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Maisel NC, Blodgett JC, Wilbourne PL, Humphreys K, Finney JW. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?. Addiction. 2013;108(2):275-93.

  3. Jarvis BP, Holtyn AF, Subramaniam S, et al. Extended-release injectable naltrexone for opioid use disorder: a systematic review. Addiction. 2018;113(7):1188-1209.

  4. Lee J, Kresina TF, Campopiano M, Lubran R, Clark HW. Use of pharmacotherapies in the treatment of alcohol use disorders and opioid dependence in primary care. Biomed Res Int. 2015;2015:137020. doi:10.1155/2015/137020

  5. Whelan PJ, Remski K. Buprenorphine vs methadone treatment: A review of evidence in both developed and developing worlds. J Neurosci Rural Pract. 2012;3(1):45-50. doi:10.4103/0976-3147.91934

  6. U.S. Food and Drug Administration. VIVITROL. Medication Guide.

  7. Mysels DJ, Cheng WY, Nunes EV, Sullivan MA. The association between naltrexone treatment and symptoms of depression in opioid-dependent patients. Am J Drug Alcohol Abuse. 2011;37(1):22-6. doi:10.3109/00952990.2010.540281

  8. Alkermes, Inc. Vivitrol.

Additional Reading

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.