Deciding to embrace a life free of drink or drugs is the first crucial step in an ongoing journey and all recovery takes on many different forms.
Depending on the nature of the addiction and the substance in question, treatment also varies considerably.
Often, medication-assisted treatment is necessary to minimize cravings, reduce the unpleasant side effects experienced during withdrawal, and also to lessen the chance of relapse. This is especially true when the addiction is more severe and withdrawal symptoms likely to be equally severe.
Today, then, we’ll take a detailed look at Vivitrol, so what is this drug, and is it as effective as you’ve been led to believe?
Vivitrol and Opioid Addiction
Vivitrol is an opioid antagonist.
The core purpose of this medication is to help you overcome the cravings you’ll experience during the early stages of withdrawal from opioid addiction.
Opioid addiction is a chronic and relapsing disease with both physical and psychological effects. Withdrawal can be remarkably tough and unpleasant without MAT (medication-assisted treatment).
A STAT survey of leading health experts projected a potential 500,000 deaths from opioid abuse in the US over the coming decade. It’s clear that serious action is needed to arrest this disturbing and continuing problem.
Vivitrol can also be used in treatment against alcohol dependence, but for the purposes of today, we’ll be focusing on its role in countering opioid addiction. It’s still not clear how Vivitrol works with alcohol, although it appears to change how the brain views alcohol consumption.
Vivitrol is Naltrexone in extended-release form. It binds to the opioid receptors in your brain so these receptors will not be activated by further opioid use. In plain English, if you continue to take opioid pills with Vivitrol in your system, you won’t notice any effects.
As the first non-addictive, non-narcotic treatment for opioid addiction, Vivitrol is now an FDA-approved medication for this purpose. The FDA approved Vivitrol for treating alcohol dependence back in 2006.
Until recently, opioid addiction has customarily been treated with methadone or suboxone. As recently as May 2017, the Us Secretary of Health and Human Services, Tom Price, made an unfavorable statement about these treatment options. Price stated that they were merely “substituting one opioid for another”. Rather than methadone or suboxone, Price suggested Vivitrol as a superior medication.
Unlike competing medication, Vivitrol cannot be abused in its own right, and there’s no black market for the drug since it’s not open to abuse. Also, the slow-release nature, as we’ll examine below, removes the need for daily administration.
But, if you’re looking to embrace a life that’s truly substance-free, is Vivitrol a magic bullet or overhyped? Before we explore this idea more fully, how does it work exactly?
How Vivitrol Works
Vivitrol is administered in the form of a monthly injection.
By binding tightly to opioid receptors in the brain, Vivitrol prevents you from getting high if you choose to take opioids. This renders attempting to further abuse your prescription painkillers pointless.
A single 380mg dose is given once monthly by intramuscular injection. A medical professional must administer the drug. From the point of injection, Vivitrol is slowly and continuously delivered due to its extended release formulation.
This streamlines medication compliance since there’s no chance of forgetting to take a dose, and there’s no way you can decide not to take the medication either, as it’s already working its way through your system.
You must be opioid-free for at least 7 to 10 days before starting treatment with Vivitrol. To this end, the drug is normally administered after detox.
Due to the slow-release nature of Vivitrol, effects diminish over the course of a month and you’ll then receive another injection.
So far, so good.
How do these advantages stack up when set against the cost of the drug, though?
Vivitrol: Cost vs Convenience
On the one hand, Vivitrol eliminates many of the traditional obstacles that can hinder recovery from opioid addiction and hamstring lasting sobriety.
You won’t need to remember to take a daily pill, and you won’t be able to refuse to take one either. That’s one less thing for you to worry about in the early stages of recovery, and one less poor decision to be tempted with making.
Crucially, you won’t have any chance of developing a secondary addiction either.
These factors seem to make Vivitrol the obvious solution and a superior alternative to the old guard of methadone and suboxone. This convenience comes at a significant cost, though. With methadone costing a mere $15 for a month’s supply, and suboxone roughly $50 per month, a Vivitrol injection is a hefty $1000 with private insurance and $500 per shot even under the Affordable Care Act.
So, Vivitrol might prevent you needing to hustle to the doctors on the regular, but the cost is pretty eye watering.
How Effective is Vivitrol for Opioid Addiction?
It’s clear that Vivitrol can be effective at reducing cravings but how about actual studies.
In a double blind clinical trial in Russia used to secure FDA approval, more than 50% of patients addicted to heroin remained abstinent for the duration of this six-month placebo-controlled study.
Vivitrol was three times more effective at preventing relapse than a daily dose of Naltrexone. Cravings were reduced by 55%.
The study showed those taking Vivitrol were 17 times less likely to relapse to the point of physical dependence than those given a placebo. They were also more likely to stay in treatment for longer.
We’ll look now at who Vivitrol is suitable for and where it is not the best course of treatment.
Who Should Take Vivitrol?
Firstly, Vivitrol should be considered as one factor in an effective treatment plan. Using the drug in and of itself is by no means a cure to what should be considered a treatable disease.
It is, though, remarkably useful for reducing cravings and it can certainly help to prevent relapse.
Vivitrol is indicated in the following instances:
- Preventing relapse to dependence on opioids as long as you have undergone detoxification first and you are opioid-free
- Forming part of an overall treatment plan including counseling rather than used in isolation
- Treating alcohol dependence assuming you have stopped drinking already in an outpatient backdrop
Who Should Not Take Vivitrol?
As with any medication, Vivitrol is not suitable in all cases.
Vivitrol is contraindicated in the following cases:
- When you are still taking opioids
- When you are still physiologically dependent on opioids
- During the phase of acute opioid withdrawal before detoxification
- When you are is hypersensitive to Naltrexone
Caution is advised if you have kidney or liver problems.
You should also speak with your healthcare provider before taking Vivitrol if you are pregnant.
Vivitrol Side Effects
So, Vivitrol is effective, not habit-forming and delivers no high so what about the side effects.
There are, unfortunately, significant risks that should be taken into full account before starting any treatment with Vivitrol.
These risks include:
- Sudden Opioid Withdrawal
- Risk of Opioid Overdose
- Reactions at Injection Site
Sudden Opioid Withdrawal
The first serious side effect is sudden opioid withdrawal. This is always the case when you abruptly stop taking opioids.
You should have stopped taking opioids and any medication containing Methadone or Buprenorphine for at least 7 to 10 days before taking Vivitrol.
By beginning a course of Vivitrol before this, you can experience withdrawal symptoms so severe as to require hospitalization.
This can be avoided by abstention in the period leading up to treatment. Vivitrol is then administered following detoxification in an in-patient facility.
Risk of Opioid Overdose
The risk of an opioid overdose comes about due to the way Vivitrol blocks the effects of opioids. Outside of a controlled setting, some people attempt to overcome this by taking larger doses of opioids. This does not have the required outcome, but can certainly result in an overdose.
Since opioid overdose can cause serious injuries, coma, and even death, the importance of abstention when using Vivitrol cannot be emphasized strongly enough.
There’s a secondary issue relating to overdose due to the diminishing effects of Vivitrol over the course of the month. While these blocking effects will gradually diminish, taking street opioids at the same quantity as before using Vivitrol can also lead to an unintended overdose. The same is the case with any medication containing opioids.
Sensitivity to opioids can be increased after detox, immediately prior to a dose of Vivitrol or even after stopping treatment completely.
Immediate medical help is required in the event of any of the following:
- Difficulty breathing
- Slow or shallow breathing with very little chest movement
- Drowsiness accompanied by slow breathing
- Faintness, dizziness, confusion
Don’t leave things to chance if you or a family member experiences any of the above symptoms and you suspect an opioid overdose.
Reactions at Injection Site
Severe reactions can break out at the injection site. These can result in tissue death and require surgery if left untreated.
Get in touch with your healthcare provider immediately in the event of any of the following:
- Extreme pain
- Any hardening around the injection site
- Severe swelling
- Lumps forming
- Scabs, especially when dark in color
- Open wounds
Other Side Effects
As with many forms of medication taken to alleviate problems with addiction, an unfortunate side effect of Vivitrol is depression. This can be so severe as to include suicidal thoughts.
The problem is that this issue is always tough to conclusively analyze. Let’s face it, if you’re suffering from opioid addiction and going through the turmoil of detox, withdrawal and recovery, chances are you’re already feeling low.
The key is to remain honest and open with your family and carers and make sure these thoughts remain just that: thoughts.
What Are The Alternatives To Vivitrol?
There are 3 main alternatives to Vivitrol for the treatment of opioid addiction:
Suboxone (buprenorphine) is a semi-synthetic opioid capable of partially activating the brain receptors responsible for craving opioids.
Dosage is tailored so as to reduce cravings without making you feel high.
Approved by the FDA back in 2002, suboxone remains a popular course of treatment, and it was historically taken in pill form.
In 2016, the FDA approved an implant capable of administering slow-release buprenorphine – Probuphine – over a six-month period.
Like Vivitrol, suboxone has been proven to help with the long-term treatment of opioid addiction. During the course of studies at inpatient facilities from 2014 to 2017, more than half of patients remained drug-free for the duration they were monitored.
The longer lasting form of suboxone is favored for increasing patient compliance and minimizing the chances of deliberate overdosing.
Suboxone is recommended by the World Health Organization, the Department of Veteran Affairs and the Centers for Disease Control and Prevention as a first line of attack against opioid addiction.
The oldest frontline treatment against opioid addiction, methadone delivers a safe level of opioids to mitigate cravings and prevent withdrawal effects.
This maintenance drug is best used over a longer period and patients are eventually tapered off the drug, if possible.
Regulation is tight and, unfortunately, a black market for the drug exists since there is potential for abuse.
The only difference between Vivitrol and naloxone is the time over which they take effect.
Vivitrol, as outlined above, is a longer-acting opioid antagonist used to help with ongoing sobriety.
Naloxone, by contrast, kicks in quickly and provides immediate relief. It’s often used to counter the effects of an opioid overdose.
How To Get Treatment with Renaissance Recovery
Vivitrol clearly shows promise as a method of treatment for opioid addiction and alcohol abuse.
More research is required and it should certainly not be considered a cure against opioid addiction, but it does have a number of apparent benefits.
There’s a vocal body attacking the manufacturer of Vivitrol, Alkermes, for aggressively marketing and lobbying for this medication. The company is also accused of unjustly knocking the competition. This is not an argument we’re entering into, so we would suggest examining all your options if you’re suffering from opioid addiction and to determine which form of treatment would work best for you. That’s all that counts, as recovery should always be personalized.
Feel free to contact our friendly team here at Renaissance Recovery if you’re in any doubt about Vivitrol, or if you need help with any element of addiction. We’re here to help you get back on track and all you need to do is call us at 866.330.9449 to get started down the road to lasting, meaningful recovery from opioid addiction.