How Helpful is Vivitrol for Alcohol Use Disorder?

What is Vivitrol?

Vivitrol is a once-monthly non-addictive injection that contains naltrexone. It is proven to help reduce heavy-drinking days in alcohol-dependent people when used with counseling. It is not a narcotic, but rather, works by blocking the opioid receptors in the brain.

If you are ready to quit or cut back on drinking, there are different approaches. Examples include behavioral treatments, counseling, self-help groups, and medications. The use of medications, in combination with counseling, is known as Medication-Assisted Treatment (MAT).

Vivitrol is a consideration for MAT. Note, however, that such treatment is individualized. Accordingly, it is important to discuss treatment options with your healthcare provider. Vivitrol is a prescription medication that must be injected by a healthcare provider.

Additionally, Vivitrol is used to treat opioid use disorder. It can help prevent relapse if you are opioid-dependent. Again, this is usually in combination with counseling. You must be opioid-free for at least 7 to 14 days to avoid opioid withdrawal.

How does Vivitrol work?

Your brain receives stimulation from things you do. When you do something you enjoy, your brain releases chemicals called endorphins. A simple example of this is when you have a delicious meal.

Endorphins attach to opioid receptors in the brain. This process leads to your brain releasing dopamine. This chemical gives you a good feeling to reward you for doing something. As a result, you develop the urge to repeat this behavior.

When you drink alcohol, your brain releases endorphins. These endorphins, however, cause the release of more dopamine than normal, enjoyable activities. Consequently, you experience a “high.” When the “high” ends, your brain craves this feeling and begs for you to repeat the act.

Vivitrol is an opioid antagonist. Thus, it blocks the opioid receptors in the brain. During this process, Vivitrol does not cause a release of dopamine. As a result, this medication does not cause you to develop a “high.” You cannot develop physical dependence or addiction to Vivitrol.

A dose of Vivitrol injection blocks the opioid receptors in your brain for one month at a time. This extended action means you are likely to experience fewer heavy-drinking days for the month.

Who Should Not Receive Vivitrol?

You should not receive this medication if you are:

• Taking prescription opioids
• Abusing street opioids like heroin
• Physical dependence on opioids
• Experiencing opioid withdrawals
• Positive urine drug screen for opioids
• Failed naloxone challenge test
• Allergic to naltrexone or any of the ingredients in Vivitrol

Before you receive this medication, you must tell your healthcare provider the following:

• Planning to become pregnant or are currently pregnant
• Liver problems
• Abusing illegal drugs
• Have hemophilia or other bleeding problems
• Kidney problems, or any other medical conditions
• Breastfeeding
• List of your current medications

Serious Side Effects

Vivitrol can cause some severe side effects. The commonest are:

1. Risk of an opioid overdose.

You can accidentally overdose if you are receiving Vivitrol. Hence, the need to be careful with this medication. An overdose can happen in two ways:

• When you take naltrexone injection, it blocks the effects of opioids. These can be opioid pain medications or street drugs like heroin. Some people may try to ingest large amounts of opioids to overcome this blocking effect. Unfortunately, this can lead to overdose, and as such coma, or death.
• After a dose of Vivitrol, it’s blocking effect slowly decreases over time. Using opioids in amounts you previously tolerated can lead to overdose and death. You may also be more sensitive to lower amounts of opioids:
  • After you have gone through opioid detox
  • When your next Vivitrol injection is due
  • If you miss a dose of Vivitrol
  • After you stop Vivitrol treatment

2. Severe injection site reactions.

This medication is given as an injection. Hence, a reaction at the injection site is a possibility. Vivitrol must, therefore, be injected with care. Such reactions may include swelling, intense pain, lumps, blisters, or an open wound. For this reason, professional administration is necessary.

3. Sudden opioid withdrawal.

You must avoid all opioids before taking Vivitrol. Sudden withdrawal can occur, otherwise. Opioid withdrawal can be very uncomfortable. Moreover, the discomfort may cause a relapse. So, a history of abstinence is necessary prior to naltrexone injection. Avoid any opioid for at least 7 to 14 days before starting this medication.

4. Liver damage or hepatitis.

Naltrexone can cause liver inflammation and damage. Therefore, it is necessary to get baseline liver tests. Liver damage can initially present as:

• Stomach pain
• Dark urine
• Fatigue
• Yellowing of the whites of your eyes

5. Depression and suicidality

Vivitrol can sometimes cause depression. Although rare, it is vital to monitor your mental state. Symptoms can include low mood, loss of interest, lack of motivation, and poor appetite. Other presentations include a change in sleep pattern, hopelessness, and even suicidal thoughts. It is essential to follow up with a mental health provider if this happens.

6. Pneumonia

Some people receiving treatment have experienced a specific type of pneumonia. It is usually due to an allergic reaction – Eosinophilic Pneumonia. Sadly, this can be quite serious. Indeed, hospitalization may be necessary.

7. Serious Allergic Reactions

Even though this is not common, it is worth noting. When it does occur, it can cause:

• Swelling of your face, eyes, mouth, or tongue
• Difficulty breathing
• Dizziness
• Chest pain

Common Side Effects

These include:

• Nausea
• Vomiting
• Headaches
• Drowsiness
• Decrease in appetite
• Muscle cramps
• Painful joints
• Cold symptoms
• Difficulty sleeping
• Toothache
• Diarrhea
• Anxiety
• Rash
• Hypertension

Steps To Receive Vivitrol Injection

The first step is consulting with your healthcare provider. Naltrexone injection is available in several primary care and mental health clinics. A proper assessment will confirm if this is the best medication for you. It is best to stop drinking alcohol before you start treatment.

Many insurance plans cover Vivitrol. Also, there is a co-pay savings program available. Your healthcare provider sends a prescription to a specialty pharmacy. You will receive a call from this pharmacy to verify some information. Following this, your naltrexone injection is delivered to your healthcare provider’s clinic. You will receive the medication in the clinic.

After receiving the injection, you will receive a card, tag or bracelet to carry around. You want to take this around for medical reasons. In case of an emergency, the medical team must know you are on long-acting naltrexone. This information is crucial to managing pain.

Treatment providers for naltrexone injection can be found online. The “Find A Treatment Provider” tool narrows down the available sites in your area. You can also get more information on this medication by calling the Vivitrol2gether program. You can reach them on 1-800-VIVITROL.

Reversal of Vivitrol Blockade for Pain Management

There are benefits to using naltrexone injection in alcohol use disorder. As we know, emergencies can happen. Such circumstances may require pain management. In such cases, a regional analgesia is an option. Also, non-opioid pain medications are another consideration.

In some emergencies, opioid pain medications may, however, be necessary. In this scenario, the Vivitrol blockade is reversed in a setting with trained staff and specialized equipment. You will undergo close monitoring during this process.

Due to the possibility of an emergency, you must carry around your Vivitrol card, tag, or bracelet.

Vivitrol is not a Silver Bullet!

Vivitrol helps some people with alcohol use disorder. It is crucial to note, however, that this medication is no silver bullet. It does not help everyone. Indeed, there is no single approach to addiction treatment. You must work with a healthcare professional to discuss the best treatment option for you. One of the beauties of medicine is the availability of multiple treatment options in some cases. While Vivitrol may do nothing for one individual, it may be the magic elixir for someone else.

This medication is also helpful in treating opioid dependence. Again, it is vital to relay a significant risk that can occur with this medication. Some studies show an increased risk of fatal overdose when people use opioids after a period of abstinence. For this reason, some healthcare providers consider other opioid treatment options. Buprenorphine and methadone are other available therapies for opioid addiction.

Even though Vivitrol is not a silver bullet, there is no doubt that it is helpful. Considering the adverse effects of addiction, it is certainly worth a try. It just may be what works the best for you.

Conclusion

Vivitrol is a prescription injection given monthly. It contains naltrexone in a long-acting form. The indications for this medication are alcohol and opioid dependence.

Naltrexone injection is a component of Medication-Assisted Treatment. Thus, it is part of a comprehensive treatment approach. Counseling and behavioral therapies are crucial components to ensure success with this medication. It helps to reduce heavy-drinking days in alcohol-dependent people.

Vivitrol is an opioid antagonist. Thus, it blocks the opioid receptors in the brain. Vivitrol does not cause a release of dopamine. As a result, dependence or addiction to Vivitrol does not occur. Before receiving naltrexone injection, you must abstain from opioids for 7 to 14 days.

Serious side effects of this medication include the risk of opioid overdose, sudden opioid withdrawal, and injection site reactions. Also, depression, liver damage, and pneumonia can occur.

Vivitrol is only given in clinics after prescription by a healthcare provider. Treatment locations near you can be found online using the “Find a Treatment Provider” tool.

Pain management may be necessary for emergencies such as vehicle accidents. In such cases, a regional analgesia is an option. Also, non-opioid pain medications are another consideration.

In some emergencies, opioid pain medications may, however, be necessary. In this scenario, the Vivitrol blockade is reversed in a setting with trained staff and specialized equipment.

Even though Vivitrol is a helpful medication, it is not a silver bullet. It does not help everyone. Indeed, there is no single approach to addiction treatment. This medication is only one of the tools in a comprehensive treatment plan. You must work with a healthcare professional to discuss the best treatment option for you.

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The entire content of AddictionBlueprint, including content on drugs and alcohol, medications, therapies, facilities, spotlights, recommendations, and other features is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. This does not constitute a physician-patient relationship. Please seek the advice of your physician or other qualified health providers regarding your addiction, mental and medical issues.