The battle against substance abuse continues to evolve. Thankfully, we have come a long way from the early days of fighting addiction when quitting cold turkey and prayers were the most powerful weapons in the arsenals of the treatment world. Now, there are a wide array of treatments, including various types of medication-assisted therapy. One of the most promising examples is Vivitrol, a type of medication that can help reduce opioid or alcohol cravings.
What Is Vivitrol and How Does It Work?
Vivitrol—also known as naltrexone—is a type of medication that can help people who are struggling with opioid addiction. It is known as an “opioid blocker” and works by binding to the same receptors in the brain that allow an individual to feel a euphoric feeling when they take an opioid. This can combat the chief source of someone’s addiction to opioids, reduce cravings, and ultimately help lead them to kick their habit entirely.
Vivitrol is also one of the few types of medications that can also assist with helping someone who has developed an alcohol use disorder. Vivitrol also changes how the brain reacts to alcohol, reducing feelings of intoxication and euphoria.
Vivitrol is non-intoxicating in and of itself. There is also no dependency created when someone takes Vivitrol, so it is non-addictive. This means that there is no potential for misuse or diversion, and this creates an advantage over other forms of medication-assisted therapy that are ripe for abuse because they do create euphoric feelings.
However, taking Vivitrol is not as simple as popping a pill. It must be administered by a health care professional at a licensed facility. It must also be taken once a month for maximum effectiveness. There are minor side effects associated with the injection, including some pain and tenderness. However, by and large, Vivitrol is relatively safe to use, although individuals who receive injections should watch for other side effects.
The monthly administration helps ensure compliance; an individual needs only to visit a doctor’s office once a month in order to stay compliant with their treatment. This is much easier for some individuals than taking a medication daily.
Vivitrol works on a time-release basis, but its “blocking” effect decreases over time. This means that an individual who takes Vivitrol will see a lowered impact toward the end of their month on the drug, and this potentially creates a danger at the end of a dosing period.
What Does the Evidence Say About Vivitrol’s Effectiveness?
Vivitrol is not the only form of medication-assisted therapy available for individuals who are struggling with opioid or alcohol use disorder. However, it does appear that Vivitrol is an effective form of therapy for people who are trying to break their opioid habits.
A recent study compared regular injections of Vivitrol to a placebo group in which patients were not given any such treatment. The study made some striking conclusions about the effectiveness of Vivitrol. It showed that those who took the medication had an:
- Extended period of opioid-free weeks compared to people in the placebo group
- Increased likelihood of remaining opioid-free, even after a 24-week period
- Increased likelihood of completing the study at all due to the effectiveness of the medication
The same study is used on Vivitrol’s website as part of their proof of concept. The study also notes that there are limitations, including that the demographics of the participants were mostly young white men and that this may limit the applicability of the study to society as a whole. It also notes that the study took place in Russia, so there may be questions about whether or not it would have the same impact in America.
However, other studies have found similar results. A 2017 study found that Vivitrol was an effective method of treating individuals who are addicted to opioids and was slightly more effective than Suboxone, another medication commonly used to treat opioid use disorder. That study found that 52% of people on Vivitrol relapsed, compared to 56% of those on Suboxone who relapsed.
However, the same study also noted major issues with Vivitrol. An individual must complete detox before they can take Vivitrol. This, unfortunately, presents a major barrier to starting the medication, with 28% of participants unable to start the use of the drug because they could not successfully detox. Furthermore, Vivitrol is expensive. These two issues present serious barriers for people to start Vivitrol and get treatment. However, if someone can make it through the detoxification period and start Vivitrol, they are more likely to succeed on this drug than Suboxone.
These are not insignificant barriers. Detox is often the most difficult part of rehabilitation for anyone with a substance use disorder. An individual who is actively attempting to detox will likely need round-the-clock supervision and may need intensive medical care in order to manage their withdrawal symptoms. Generally speaking, this is not a process that anyone should attempt without medical supervision.
Vivitrol and Alcohol
Vivitrol is one of the few medications that may be useful for treating alcohol use disorder. According to the manufacturer’s website, Vivitrol can help treat alcohol dependence and reduce “heavy drinking days.”
Like opioid use, an individual should detox from alcohol and stop drinking before they take a Vivitrol injection. Once someone does take the substance, it will work in a manner similar to the way that Vivitrol works for opioids; it will block the alcohol from activating the pleasure centers of the brain. This means that drinking alcohol will not feel nearly as good, and this should, in turn, reduce alcohol cravings. This will not make someone sick when they drink, unlike other drugs. It simply means that drinking alcohol won’t feel as enjoyable.
Of course, for many, drinking to feel good is not the primary reason why they drink. Those reasons must be explored with therapy and counseling. Just like using Vivitrol for opioid use, you must engage in counseling while using Vivitrol in order to get the full benefit of the medication.
However, there is good news: Studies show that Vivitrol may work for treatment of alcohol use disorders. A randomized study showed that people who took Vivitrol had 25% fewer “heavy drinking” days, meaning that these individuals were less likely to drink excessively than individuals in a placebo group. The same study showed even more significant results among individuals who received psychological counseling while taking Vivitrol and also showed that this drop was more pronounced than people who only sought counseling. The fact that Vivitrol works for both opioid use disorders and alcohol use disorders makes it a potentially game-changing medication for individuals who are suffering from both disorders.
Vivitrol and Counseling
As is noted on Vivitrol’s website, the substance MUST be used with counseling in order for it to be truly effective. This is different than some other forms of medication-assisted treatment that don’t necessarily require the use of therapy.
Generally speaking, however, the combination of counseling and medication-assisted therapy is regarded as the “gold standard” of drug or alcohol treatment. Vivitrol is still a relatively new form of treatment, though. As such, there is no data that reviews what specific form of counseling works best with Vivitrol use.
Indeed, there are many forms of counseling for opioid use withdrawal, including cognitive behavioral therapy and motivation therapy. Hopefully, future studies will give a better idea of what types of therapy work best in combination with medication-assisted therapy.
Side Effects of Vivitrol
It is important to note that there are real side effects associated with the use of Vivitrol. These include dizziness, headaches, pain, nausea, upset stomach, vomiting, fatigue, and more. Furthermore, individuals with liver or kidney damage should not take the drug as there is concern about what it may do to individuals who already have compromised organs.
In some cases, serious side effects can develop, including liver problems or suicidal thoughts. Individuals should be told that these are potential side effects of the drug and monitor accordingly.
One of the challenges with Vivitrol is that an individual must not be using opioids when they first take the drug. Detoxification is required before someone uses Vivitrol, and depending on the individual in question, they must be clean for seven to 14 days before receiving a Vivitrol injection. If someone does use opioids in this time period and then receives a Vivitrol injection, the individual in question may suddenly feel opioid withdrawal symptoms. This, of course, may reverse the positive impact of taking Vivitrol.
As such, getting an individual to a point where they can take Vivitrol may require an intensive monitoring and counseling process. Thankfully, all available evidence shows that Vivitrol works best in conjunction with counseling or other forms of behavioral therapy. This lines up with other medication-assisted treatments.
Potential Dangers of Vivitrol
As noted by the manufacturers of the drug, Vivitrol changes the brain chemistry in order to help individuals overcome their opioid or alcohol addiction. However, this can unwittingly create two additional dangers if someone does use opioids.
First, an individual who uses opioids while on Vivitrol will not experience the same high or intoxication that they had previously experienced. Indeed, this is chiefly how Vivitrol is supposed to work; it can reduce an individual’s cravings for opioids by changing their brain chemistry. However, some individuals may try to overcome this “block” by taking more opioids than they ever had previously. This can have deadly consequences and lead to an overdose.
Second, as noted above, Vivitrol’s effects decrease over time. If an individual does use opioids at the same level that they previously had toward the end of that month, the combined impact of the Vivitrol and opioids may be enough to result in an overdose. Again, this is why it is so important that an individual only begin to use Vivitrol after successfully completing detox and in conjunction with other forms of therapy. While Vivitrol can unquestionably help save lives, it also has the potential to endanger someone who uses opioids while on the medication.
If you or someone you love is struggling with an opioid use disorder, remember that there are options for help. At Granite Recovery Centers, we specialize in helping individuals overcome their opioid use disorders in a variety of ways, including research-based counseling and via the administration of appropriate medication-assisted therapy, like Vivitrol. For more information, explore our website or call us at (855) 712-7784. With the right help and support, a new life free of drugs and alcohol is possible.