Vivitrol Treatment for Alcoholism and Addiction

How the Medication Changes Your Brain's Reaction to Alcohol

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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.


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:

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

Other potential serious side effects of Vivitrol include:

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

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

  • Inflammation of nasal passages
  • Increased liver enzymes
  • 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.

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