Vivitrol Shot for Alcohol and Opiate Recovery - What You Need To Know
What Is Vivitrol?
Vivitrol® is a brand name of a long-acting naltrexone injected suspension. Vivitrol treatment is a medication assisted treatment used for alcohol and opiate dependence.
What Is Naltrexone?
Naltrexone is a medication that acts as a competitive antagonist to the mu opioid receptors in the body. These receptors are found all over the body, especially in the brain and the gut. The opiate molecules (endorphines) our body's naturally make attach to these receptors. Opium, heroin, morphine, and the other opiates, including Suboxone, attach to these receptors also.
Competitive antagonist simply means that for these specific receptors, the naltrexone goes into the spot where an opiate normally would and it directly blocks the opiates from attaching there. The naltrexone has a greater affinity for the receptor site than all other opiates, ie. it holds on tighter. If there's an opiate there, it will kick it out and occupy the spot. When this happens, withdrawals happen. These are called precipitated withdrawals and they are intense! This can be avoided but it's one of the reasons someone who understands this body chemistry well should be administering the Vivitrol shot.
Why Naltrexone For Opiate Dependence?
Since naltrexone blocks opiates from binding the the mu receptors, once the the naltrexone is there, you essentially can't get high from opiates anymore. Naltrexone is essentially a really effective security blanket to opiate relapse. For most people, physical craving is usually diminished with naltrexone as well.
Why Naltrexone For Alcohol Dependence?
Naltrexone has a couple of useful effects in alcohol use disorder. One is that for most people, it significantly reduces or eliminates craving. This helps reduce relapse. Secondly, if you do drink alcohol, you don't get sick like with the medication Antabuse, but it is not the same experience. Drinking alcohol on naltrexone takes out the pleasurable feeling and makes it much less enticing in this way also.
Why Vivitrol And Not Pills?
That's easy. You can choose to not take a pill. I can't tell you how many times I've had people refuse Vivitrol and take naltrexone pills daily, only to relapse weeks or months later because life got stressful and they decided not to take their medication because whether consciously or subconsciously, they wanted to get high or drink.
How Long Does Vivitrol Last?
It lasts ~28-30 days. It is a once a month injection.
How Does It Last A Month?
Vivitrol injection comes in two separate vials. One is a liquid and the other is microspheres/beads containing naltrexone. When you mix the two together, it turns into a milky consistency. This gets injected into a big muscle like the gluteus maximus (butt muscle) and within short order, the solution solidifies, basically turning into a little pellet of naltrexone that dissolves over a month so that there's always naltrexone present in the bloodstream.
What are Vivitrol side effects?
There are two primary considerations for you and your practitioner to take. In a small portion of individuals, the medication is hard on the liver and liver enzymes will go up. Sometimes the liver enzymes are high already from substance use or an infection like Hepatitis C. In these cases, I personally still use it and the liver enzymes come down after the substance is removed or the infection is treated.
As a personal anecdote, I've treated literally hundreds of patients with long-acting naltrexone and never had anyone's liver enzymes go up. It's something to be aware of and also of little concern to me at this point in my career.
The second consideration, which is not exactly a side effect, is in opiate relapse while under naltrexone treatment. As mentioned before, using opiates will have no effect essentially. At least not the desired ones. If someone decided to take enough opiates to try and overcome the Vivitrol shot and get high, they'd most likely overdose before or at the point where that could happen. NEVER TRY THIS!
Most insurances cover it at this point in the U.S. If you don't have insurance or are traveling down from Canada to get the Vivitrol shot, it will cost somewhere around $1200-$1300 for the medication. Yes, that is quite expensive, but probably the lowest average daily cost of heroin use by my patients historically has been $40/day. $40x30days $1200/month. Many people use more than that a day. Besides that, getting clean and sober is saving you a lot more than money.