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How Does Vivitrol Work?

When the opioid crisis became an endemic problem in the United States, doctors, health experts, and authorities had to come up with a strategy to deal with it. A 2017 report on Vox explains that Vivitrol is one of the many tools the medical community has in the fight against the opioid epidemic. 

Also known as naltrexone, Vivitrol is a medication that may be able to help people who do not respond well to methadone or buprenorphine — other medications used for people who misuse opioids. 
Vivitrol is a nonopioid medication that can help people who feel that taking methadone just switches out one opioid for another one.

Vivitrol requires a monthly injection instead of a daily dose, which is very appealing to many users.

Why Vivitrol Is Used  

Vivitrol (naltrexone) works by blocking the effect of opioids and reducing cravings to these drugs. Per MedlinePlus, it is an opioid antagonist, which means it has the opposite effects of opioids. It is best used as part of a recovery program and in conjunction with other strategies to help you stay away from drugs. 

A tablet form of naltrexone is available, but SAMHSA explains that Vivitrol is its injectable alternative. The tablet form of naltrexone must be taken as your doctor instructs. It may be taken once per day, every two days, or at other intervals, depending on your needs. This can make it difficult to stay on top of your medication. 

Vivitrol injections can be administered once per month, which makes it easier for people to take throughout their recovery.
The U.S. Food and Drug Administration’s (FDA) Medication Guide for Vivitrol explains that this medication works by blocking the effect of opioids on your body. But the medication can also pose risks that can increase your likelihood of overdose.

If you have detoxed from opioids while using Vivitrol, you start to lose tolerance to opioids because they are no longer in your body. Your risk of overdose increases if you take opioids and illicit drugs immediately after taking Vivitrol, even if you take an amount that is lower than what you used before. This risk increases when you stop taking the medication when you miss a dose, or when you stop treatment with Vivitrol.

Side Effects of Vivitrol

Like any medication, Vivitrol also causes side effects. Per MedlinePlus, some of these can be fairly mild.

  • Headaches
  • Teary eyes
  • Nausea
  • Constipation

More severe side effects include the following:

  • Difficulty sleeping
  • Rash
  • Sleepiness
  • Fatigue
  • Joint or muscular pain

The following side effects require immediate medical assistance:

  • Confusion
  • Hallucination
  • Vomiting and diarrhea that last a long time

If you feel side effects after using Vivitrol, talk to your doctor so they can adjust your dose. Do not stop taking it without first consulting your physician. People with hepatitis should not take Vivitrol.

Other known complications from the use of Vivitrol are:

  • Skin reactions at injection sites
  • Injury to the liver in some people
  • Pneumonia caused by an allergy to Vivitrol

Vivitrol can also injure the liver if used at high amounts. It is vital that people look out for signs, such as:

  • Yellowing of the eyes
  • Dark-colored urine
  • Consistent tiredness
  • Stomach Ache that lasts more than several days

It is important to avoid driving a car or using heavy machinery once you have started using Vivitrol. The FDA also mentions that in some cases, Vivitrol can cause changes in your mood. 

Some people report feeling depressed when taking Vivitrol.

Other signs of changes in mood are:

  • Thoughts of self-harm
  • Differences in sleep patterns (sleeping much more or less than you usually do)
  • Feeling angry or irritable at things that did not make you feel this way before

How Vivitrol Blocks a High

According to SAMHSA, Vivitrol works by binding to opioid receptors in the brain. This then blocks euphoric feelings that cause you to feel high.

In order for patients to use Vivitrol, they must detox for about seven to 10 days before they can receive the medication.

For alcohol misuse, doctors recommend using Vivitrol for up to three months. 
Naltrexone itself is not known to cause addiction, but it is possible to overdose on it, per MedlinePlus. Vivitrol is not a narcotic drug.

For Alcohol and Opioid Addiction

Vivitrol has been used as an effective treatment for dependency on and an addiction to alcohol. It works by blocking a person’s cravings for alcohol. Plus, Vivitrol is not known to have adverse reactions when taken with alcohol. 

According to the Alcohol and Drug Foundation, patients who use naltrexone because they are trying to quit opioid medications should be given alternatives to treat their pain. 

Using Vivitrol to quit the abuse of opioids and alcohol is known to be effective. In one study, 36 percent of people who used Vivitrol stayed in treatment throughout its full course compared to 23 percent of people who took a placebo. 

Can Vivitrol Cause Dependence?

Data shows Vivitrol does not cause dependence. Use the medication consistently to help you stick to your goals in recovery.

The Alcohol and Drug Foundation (ADF) also mentions that people who take naltrexone should not take it along with other drugs. Using Vivitrol along with other drugs has not been studied sufficiently, and it could cause unknown adverse reactions. 

Even though Vivitrol is not known to cause dependence, it is essential that people who are on a naltrexone program stay away from drugs as a part of their recovery program.

A few consequences of using drugs after missing a naltrexone dose or stopping the program are:

  • You become a “new” user. Vivitrol use lowers your tolerance for opioids and alcohol. This means you are more likely to experience overdose or alcohol poisoning with lower doses.
  • ADF mentions that even though Vivitrol can help with alcohol addiction, some people do not react the same way when using it to combat their use of heroin, and they may return to taking drugs. This puts a person at risk of accidental overdose if they take the same amount of heroin they once did before treatment.

Does Vivitrol Cause Withdrawal?

Vivitrol does not cause withdrawal symptoms if a person has fully detoxed from opioids and alcohol. If a person has opioids in their system, they will experience withdrawal symptoms of those drugs. 

This is why people should also be careful whenever they take opioid medication to relieve a cough, diarrhea, and other conditions. Vivitrol can also block the effects of these medicines.

Treatment

At the moment, Vivitrol is not known to be habit-forming. However, the medication is still linked to overdoses because people who are on a Vivitrol program are more likely to have adverse reactions if they relapse.

The best way to use Vivitrol is as part of a strategy to help you quit using alcohol or opioids. This should include therapy and participation in other programs that enhance recovery.

People may decide to stop receiving treatment with Vivitrol if they have liver issues or hepatitis, or if they suffer from a lesion at the injection site.

The decision to stop using Vivitrol should be made along with your doctor. Despite the fact that Vivitrol can help you quit the use of opioids and alcohol, and it does not cause addiction if you have fully detoxed, it does present some disadvantages. 

Disadvantages to Vivitrol

Vox mentions that unlike other diseases, people who want to quit using opioids have few options and agency when it comes to getting treatment. They can take methadone or buprenorphine every day, or they can choose to take Vivitrol.

All of these options are valid, but they are not always available. There are other disadvantages to Vivitrol.

  • It can be more expensive than buprenorphine or methadone.
  • Not everyone has access to Vivitrol.
  • People must be fully detoxed before taking this medication.
  • Those in rural parts of the U.S. usually do not have doctors who can prescribe Vivitrol.

Some parts of the country are taking steps to make Vivitrol available to their local populations. In March 2019, the Tennessean mentioned that two counties in the state had started a pilot program to offer Vivitrol to people who are about to be released from prison.

The program will allow for grants that let these counties hire qualified staff to run this pilot program. Former inmates who had problems with misuse can have access to this medication that can greatly assist with addiction recovery.

A Final Word

Even though Vivitrol is not known to cause dependence when a person is wholly weaned off drugs, it should not be used in combination with illicit drugs during treatment. This can have unknown harmful effects. 

People whose liver health is compromised should notify their doctors right away in order to seek alternative treatments. 

If you have been prescribed Vivitrol, it is because your physician has determined it is in your best interest to use it. You should always discuss your options with your doctor, who can help you find alternatives if you are worried about misuse or think you may relapse

Sources

(October 2017) Naltrexone. MedlinePlus. Retrieved March 2019 from https://medlineplus.gov/druginfo/meds/a685041.html

(November 2017) A new study found a big problem with a popular opioid addiction medication. Vox. Retrieved March 2019 from https://www.vox.com/science-and-health/2017/11/15/16653718/study-buprenorphine-naltrexone-suboxone-vivitrol

(September 2016) Naltrexone. Substance Abuse and Mental Health Services Administration. Retrieved March 2019 from https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone

(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

(October 2018) Vivitrol Treatment for Alcoholism and Addiction. Verywell Mind. Retrieved March 2019 from https://www.verywellmind.com/treating-alcoholism-and-addiction-with-vivitrol-67505

(July 2013) Vivitrol Medication Guide. U.S. Food and Drug Administration. Retrieved March 2019 from https://www.fda.gov/downloads/drugs/drugsafety/ucm206669.pdf

(March 2019) What is Vivitrol? How one pilot program in two Tennessee counties could fight opioid addiction. Tennessean. Retrieved March 2019 from https://www.tennessean.com/story/news/local/cheatham/2019/03/19/pilot-program-bring-vivitrol-cheatham-county-jail-expected-combat-opioids/3027727002/

(August 2018) Naltrexone. Alcohol and Drug Foundation. Retrieved March 2019 from https://adf.org.au/drug-facts/naltrexone/

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