Vivitrol is a once monthly extended release naltrexone injection that is used to help prevent relapse of opioid (heroin/hydrocodone/oxycodone) and alcohol abuse. Naltrexone is an opioid antagonist with highest affinity for the mu opioid receptor. This receptor is used by alcohol and opioids to elicit a pleasurable feeling or euphoria. However, repetitive stimulation via exogenous (outside the body) substances results in the reduction of the body’s own production of pleasure hormones (serotonin, dopamine, acetylcholine, etc.) . When individuals then attempt to abstain, it often results in depression. This depression often leads to relapse. This results in the cycle of using and short attempts at sobriety, often leading to increased hopelessness.
Vivitrol helps with this in two ways:
1. Since the mu receptor is occupied by vivitrol, physical cravings are greatly diminished or nonexistent when a triggering event happens. This does not mean that all cravings will be gone. A craving is a complex behavioral, psychological and physiological response. The habitual craving may still be present: for instance, the person who stopped by the corner store every evening after work to pick up beer will still have that habitual response when they drive by the store. However, the subsequent physical craving (compulsion) should be lessened or missing, allowing them to process their craving more effectively.
2. If opioids or alcohol is used after receiving Vivitrol, the euphoria or “buzz” should be absent resulting in the breaking of the use-reward cycle. However, consumption of alcohol can still result in intoxication just without the “high” along the way.
Maintaining sobriety for a length of time (10-12 months typically) results in the return of the body’s normal hormone (Serotonin, etc.) balance.
VIVITROL is indicated for:
- Treatment of alcohol dependence in patients who are able to abstain from alcohol in an outpatient setting. Patients should not be actively drinking at the time of initial VIVITROL administration.
- Prevention of relapse to opioid dependence, following opioid detoxification.
- VIVITROL should be part of a comprehensive management program that includes psychosocial support.
- Receiving opioid analgesics
- With current physiologic opioid dependence
- In acute opioid withdrawal
- Who have failed the naloxone challenge test or have a positive urine screen for opioid
- Who have exhibited hypersensitivity to naltrexone, polylactide-co-glycolide (PLG), carboxymethylcellulose, or any other components of the diluent.