The Pros and Cons of Vivitrol

Addiction to alcohol and opioids can often leave people feeling trapped and hopeless. Some take a “white knuckle” approach to getting clean and sober, hoping that their own willpower will prove strong enough to avoid relapse. This approach often fails because addiction affects both the body and mind.

Addiction to these substances is a chronic brain disease and must be treated accordingly. Opiate abuse can bring significant changes to the brain chemistry of users.

Many people have turned to medications in their search for sobriety. When used in conjunction with counseling, these medications can give addicted people the balance they need to stay drug and alcohol-free.

The Continued Rise of The Opioid Epidemic

By 2017, the abuse of opioids was declared a public health epidemic in the US. Doctors prescribe nearly 300 million opioid analgesics every year. In other words, enough opiate pain medication is prescribed in the United States annually for every person to get a bottle. This makes the US the world leader in opioid abuse and overdose deaths.

Drug overdose deaths have quadrupled in the US since 1999, bringing the death toll from 2000-2014 to half a million. Teens are the fastest-growing group experimenting with opioids.

Illegal drug use is also on the rise. Synthetic opiates, such as fentanyl and carfentanil, also continue to grow in popularity and availability. Fentanyl is 50 times more powerful than heroin and 100 times more powerful than morphine. Carfentanil is 100 times more powerful than fentanyl.

Unlike heroin, which is derived from the harvest of poppy plants, these drugs are created in laboratories in large quantities. This makes them less expensive.

A Growing Problem with Few Solutions

Opioids have become more numerous and readily available, but until recently, solutions for the drug crisis saw little change. In decades past, methadone was the treatment of choice for those suffering from opioid dependence.

Methadone belongs to a class of drugs called opioid agonists which mimics the effects of heroin. Due to the powerful effects of methadone and its potential for misuse, it is currently one of the most highly controlled substances in the world. Therefore, those who receive methadone treatment usually are required to take the medication daily in a clinic.

While methadone treatment has been a stalwart in the treatment of opioid addiction for decades, it has had no shortage of critics. Methadone produces a similar euphoria to heroin but is also considered by many to be more addictive and harder to withdraw from.

Patients have the ability to increase their dose exponentially much faster than they are allowed to decrease it. For this reason, many methadone patients refer to the drug as “liquid handcuffs.”

It can be extremely dangerous if it is abused or taken with other substances including alcohol. In fact, the misuse of methadone is responsible for more than double prescription overdose deaths than any other drug. In 2014, methadone accounted for 23% of opioid-related deaths.

The Search for Better Alternatives

As public awareness of the epidemic grew, so did newfound support for various alternative treatments. In 2002, the FDA approved the use of Suboxone for use in the treatment of opioid dependence.

Suboxone is a combination of Buprenorphine (a partial opioid agonist) and Naloxone (an opioid antagonist). This combination effectively stops an individual’s cravings and blocks the euphoric effects of other opioids. Patients often report feeling “like normal” again while taking Suboxone. Buprenorphine is an opioid and therefore can be addictive. Therefore, critics claimed that this was still a form of “trading one drug for another.”

In 2006, Vivitrol was released on the market. This new drug provides a new way for people who are addicted to opioids to stay drug-free without the use of another addictive substance.

What Is Vivitrol?

Vivitrol is a treatment that helps prevent relapse in opioid-dependent patients. From its inception, it offered a completely different model for treatment than its predecessors for many reasons. It effectively takes away the “high feeling” produced in the brain when using opioids or alcohol. Vivitrol lasts for up to 30 days with a single treatment. Unlike almost every other alternative, Vivitrol is completely non-addictive.

Belonging to a class of drugs called opioid-antagonists, Vivitrol attaches to the opioid receptor without triggering the release of dopamine. This effectively blocks other drugs from attaching to the receptor. Vivitrol takes away the euphoria associated with the abuse of heroin and painkillers.

Vivitrol is administered by a healthcare provider in the form of a shot. Like any other treatment for chemical dependence, Vivitrol is used as a part of a larger recovery program which includes individual and often group therapy.

The Benefits of Vivitrol

Unlike its predecessors, Vivitrol is not a narcotic and is non-addictive. Other treatments for opiate addiction involve taking a replacement chemical that partially or completely mimics the effects of opiates such as heroin or prescription painkillers. These chemicals are almost always addictive and, in turn, produce dependence.

Vivitrol has encouraging statistics on its side. Studies performed by the manufacturer compared patients getting Vivitrol against those receiving a placebo. The study showed that taking Vivitrol can significantly reduce a patient’s desire to use drugs and alcohol.

Studies have shown that people addicted to alcohol have a 90% reduction in cravings to drink. Individuals who are receiving treatment for opioid dependence show a 55% reduction in cravings.

In addition, data collected showed that opioid-dependent individuals were 17 times less likely to relapse into physical opioid dependence than people not receiving medical assistance. People taking Vivitrol stayed in treatment an average of 168 days, which was 72 days longer than those receiving a placebo.

For people dependent on alcohol, Vivitrol offers a more comprehensive form of aversion therapy. For a long time, doctors prescribed daily medications designed to take the desired euphoric effects away and even make a patient feel sick when consuming alcohol. While these treatments are sometimes successful, they only work if the patient takes the medication every day.

Many people who struggle with addiction experience difficulty with self-control and can sabotage their sobriety by simply skipping their daily dose. Vivitrol is taken once a month, giving people a much smaller window of opportunity to make a decision to compromise their sobriety. Vivitrol is also administered by a healthcare provider, which may give those who are seeking treatment the structure they need.

The popularity of Vivitrol has been growing in the US since it was approved in 2006. As a completely “drug-free” alternative, patients could take Vivitrol without any fear of getting hooked on another drug.

This has made it a favorite in the correctional system for use with inmates suffering from drug addiction. In fact, many drug courts throughout the US have decided to refer inmates to programs which administer only Vivitrol.

One of the best parts of Vivitrol treatment is the mental freedom it gives to patients. Many people who have taken Vivitrol tell of how much easier it is to refuse opioid drugs when they know they cannot get high. Patients can focus more heavily on counseling without the burden of resisting opiates.

The Cons of Vivitrol

One of the downsides of Vivitrol is the amount of time an individual must wait to administer the first dose. You must be completely detoxed from opioids for 1-2 weeks before taking Vivitrol. This includes any opiate pain medication and street drugs such as heroin. In emergencies, such as those requiring surgery, the effects of Vivitrol may need to be reversed before pain medication is administered.

One of the fears that keep people from trying Vivitrol is that they will experience severe withdrawal symptoms. Individuals who are insufficiently detoxed when they receive the initial Vivitrol treatment can sometimes experience Sudden Opioid Withdrawal Syndrome (SOWS).

Symptoms of SOWS include anxiety, restlessness, insomnia, body aches, vomiting, diarrhea, fever, shaking, increased heartbeat, high blood pressure, and even seizures.

In spite of the numerous testimonials people who have had success with Vivitrol have shared online, the stories of a few who have experienced this phenomenon seem to get the most attention.

Blocking the opioid receptor is a very small part of recovery. Vivitrol is not recommended for people who are not ready to stop using drugs. Some people attempt to convince addicted loved ones to get Vivitrol treatment. This can be dangerous for those who do not understand what Vivitrol is.

Unlike other medications such as methadone and Suboxone, users can not “override” the effects of Vivitrol by using increased amounts of opioids. Individuals attempting to do so are at high risk of overdose, stroke, or death. In addition, those who have received Vivitrol treatments are warned that using opiates after treatment, even in amounts they were previously comfortable with, can be fatal.

Vivitrol is more expensive than methadone or Suboxone. It also must also be administered by a healthcare professional, which means that patients may incur additional costs for the visit. While this has been a real deterrent to some individuals, there are coupons and voucher programs that can dramatically reduce the price.

Final Thoughts

Vivitrol offers individuals a treatment that is non-addictive and lasts up to 30 days. At Right Path Addiction Centers, we use this in conjunction with counseling to bring balance to our patients’ recovery.

Written by David Langille, MD, Addictinologist – Right Path

Dr. Langille is one of Right Path Treatment Center’s founding members and is a full-time Physician specializing in Addiction Medicine and helping patients regain their health and lives through the process of recovery.


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