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Addiction Doctor in Northborough, MA

Vivitrol is the trade name for intramuscular (IM) (a shot in a muscle) naltrexone. Naltrexone is an opioid antagonist or “opioid blocker” (it blocks the effects of opioids). IM naltrexone is an FDA approved medication that has been shown to be effective in reducing cravings for alcohol and blocking the euphoric effects of opioids.

Vivitrol is used to treat Opioid Use Disorder (OUD) (Opioid Addiction), and Alcohol Use Disorder (AUD).  It is most effective when taken in conjunction with appropriate counseling (examples include individual, intensive outpatient, partial hospitalization, and residential), and group support (including Alcoholics Anonymous/Narcotics and SMART recovery).

Oral naltrexone (Revia) has also been shown to be an effective treatment for alcohol use disorder, but not for opioid use disorder.

Addiction Is a Brain Disease

Addiction is a brain disease and when treated like a chronic medical illness, results are similar to other chronic medical illnesses such as hypertension, asthma, and diabetes.1,2 It often has its roots in genetics, mental health conditions, trauma, and unstable living situations.   Treatment for all forms of addiction often involves treatment for underlying conditions such as depression, anxiety, and trauma. Family members may also need support.

How Does Vivitrol Work?

IM naltrexone is an injection given every 28 days. It prevents the euphoria (or high) from opioids and reduces cravings for alcohol by blocking the opioid receptor in the brain. There should be a trial with oral naltrexone before IM naltrexone is given.

For OUD, there must be at least 7 days from the last use of an opioid (ex-heroin, hydrocodone, morphine, fentanyl) before starting naltrexone. Naltrexone can precipitate opioid withdrawal symptoms if there are any opioids in the system.

For AUD, the medication can be started without a period of abstinence (as long as the individual has not taken any opioids).

What Are Other Medical Treatments Are Available For Alcohol Use Disorder and Opioid Use Disorder?

Initial treatment for AUD typically involves a detox period that is often done under medical supervision in a detox facility with benzodiazepines (once the detox is complete, benzodiazepines are not recommended for individuals with AUD).

Naltrexone (oral and IM) and Acamprosate (campral) are both FDA approved medications for alcohol cravings. Other medications including topiramate and disulfiram are used for AUD as well.

Intramuscular naltrexone is one of three FDA approved forms of Medication Assisted Treatment (MAT) for Opioid Use Disorder. The other forms of MAT for OUD are buprenorphine (Suboxone) and methadone maintenance.

As mentioned above, Vivitrol (and all forms of MAT) is most effective when combined with counseling and group support.

Possible Side Effects of Vivitrol

  • If a patient stops taking naltrexone/Vivitrol after a period of abstinence from opioids, they may have a reduced tolerance to opioids and may be more prone to an opioid overdose.
  • Naltrexone is metabolized through the liver and may cause elevation of liver enzymes in individuals with underlying liver disease.
  • Naltrexone may cause nausea/vomiting, diarrhea, headaches, fatigue, anxiety, joint or muscle pain, injection site reaction or an allergic pneumonia.

View our FAQ’s page for more information.

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Reading List:

1. Volkow, N, G. Koob, and A. McLellan. Neurologic Advances from the Brain Disease Model of Addiction. N Engl J Med 2016;374:363-71

2. Mclellan AT, et.al. Drug Dependence, A Chronic Medical Illness, implications for Treatment, Insurance, and Outcomes Evaluation.  JAMA 2000: 284:1689-1695