Vivitrol

Vivitrol is a long-acting injection medication that helps treat alcohol and opioid use disorders, and is the only approved drug to treat addiction that is not addictive.

Vivitrol is one of several drugs that helps treat opioid and alcohol use disorders. As public awareness about the harmful consequences of addictive disorders has increased, more information about medications to treat addiction is now available. The usage of the Vivitrol shot has introduced a new set of potential advantages, as well as some new drawbacks.

What Is Vivitrol?

Vivitrol is the trade name for a long-acting injectable form (a shot) of the opioid reversal agent naltrexone. It is approved by the United States Food and Drug Administration (FDA) for the treatment of opioid use disorders and alcohol use disorders.

A Vivitrol shot takes the action of naltrexone, which is an opioid blocker taken once per day orally, and extends that action for one full month. A Vivitrol shot is used for treating opioid addiction — which is the most severe form of an opioid use disorder — and for treating alcohol dependence.

Background & History

Naltrexone, the active ingredient in Vivitrol, earned FDA approval for the treatment of opioid use disorders in 1984 and for the treatment of alcohol use disorders ten years later.

The pharmaceutical company Alkermes began clinical trials on an injectable form of naltrexone in the late 1990s. Throughout the 1980s and 1990s, studies showed that oral naltrexone was highly effective as a medication. However, adherence to prescribed oral naltrexone regimens was typically poor.

The injectable long-acting form of the medication appeared to sufficiently address the problem, because once the Vivitrol shot was taken, its chemical action could not be discontinued for at least one month. Vivitrol’s FDA approval for the treatment of alcohol dependence came in 2006, with Vivitrol’s FDA approval for treating opioid dependence arriving four years later.

Use in Treating Addiction

An increasing number of substance use disorder recovery programs, psychiatrists and primary care offices have made Vivitrol treatment programs available. A significant advantage to using Vivitrol treatment for opioid dependence is that Vivitrol has no addictive potential.

However, there are significant drawbacks to Vivitrol treatment, including:

• Vivitrol tends to be more expensive than other medications approved for the same purposes
• Vivitrol cannot be taken if a person has recently used opioids and is dependent on them
• Vivitrol does not treat any alcohol or drug withdrawal symptoms

Vivitrol for Opioid Addiction

Vivitrol can be an effective option for treatment of opioid use disorders, and the FDA has approved Vivitrol for opiate addiction treatment. However, what happens when you take opiates while on Vivitrol?

Vivitrol has the current distinction of being the only medication approved to treat opioid use disorders that does not have addiction potential. Unlike methadone (and Suboxone, to a lesser degree), Vivitrol will not increase overdose risk if an opioid is taken with it. In fact, the opposite is true: the naltrexone in Vivitrol can cause withdrawal symptoms if a person who is physically dependent on opioids takes an opioid. Patients must therefore abstain from opioid use for one week before taking a Vivitrol injection.

Vivitrol and Alcohol Abuse

While it may be intuitive that a medication that opposes the action of opioids could be used to treat an opioid addiction, Vivitrol was first used to treat alcohol use disorders, with the FDA approving the Vivitrol shot for alcohol dependence treatment in 2006.

Vivitrol was likely first used for this purpose because alcohol consumption activates the opioid receptors in the brain as well. Healthcare providers and treatment centers increasingly prescribe Vivitrol for alcohol abuse treatment. However, Vivitrol alcohol treatment does have a significant limitation in that it does not treat alcohol withdrawal.

How Vivitrol Works

Vivitrol is clearly useful in the treatment of opioid and alcohol use disorders, but how does Vivitrol work? Vivitrol works through the action of its primary component drug, naltrexone. Naltrexone is a long-acting antagonist, or opposing force, of the body’s primary opioid receptors. This capability helps naltrexone deactivate the effects of opioids. Thus, naltrexone can be thought of in a similar way to naloxone, or Narcan.

The primary difference between naltrexone products like Vivitrol and naloxone products like Narcan is that naltrexone does not act immediately, and the opioid-opposing effects of naltrexone last much longer.

One primary difference between oral naltrexone and Vivitrol is in how Vivitrol is administered. Vivitrol is administered as an intramuscular injection by a healthcare provider, whereas oral naltrexone is swallowed.

How Long Does Vivitrol Last?

The other primary difference between oral naltrexone and Vivitrol is how long the Vivitrol shot lasts in the body. Vivitrol injections are effective for up to one month, at which point they must be repeated.

How long Vivitrol lasts in the body generally stays consistent from person to person. After a Vivitrol injection, levels of naltrexone begin declining in the bloodstream after two weeks, though exactly how long the Vivitrol shot does last is dependent upon several individual factors, like metabolism or genetic variation.

Vivitrol Side Effects

Taking Vivitrol can result in the same side effects as taking oral naltrexone. Common Vivitrol side effects include:

• Nausea
• Headache
• Nervousness
• Restlessness
• Irritability

Additionally, liver toxicity is a rare but serious potential complication when taking any naltrexone product.

Additionally, problems with the skin at or near the injection site, such as redness, swelling, itchiness or infection can occur with the Vivitrol injection.

Taking Vivitrol While Pregnant

Animal research with Vivitrol has shown that the drug can potentially cause minor harm to animal fetuses. Human trials with the drug have been inconclusive.

Decisions about whether to take Vivitrol while pregnant must be made with a health care provider’s guidance. Overall, whether it’s safe for an expectant mother to take Vivitrol depends on whether the potential benefits outweigh the risks.

How Effective Is Vivitrol?

Studies on oral Naltrexone show an average reduction of drinking days per month by up to 50 percent, a moderate effect size in terms of a drug’s capabilities.

However, those studies had to take into account the tendency for people who are still in active addiction to not take these medications regularly. Government-funded studies of Vivitrol, which are considered the most reliable and unbiased information source, currently allow for the most accurate picture of Vivitrol efficacy.

Get More Information on Vivitrol

At The Recovery Village, Vivitrol is used as a maintenance medication (as medically appropriate) for people who have completed treatment for opioid addiction or alcohol addiction. If Vivitrol maintenance therapy is part of a client’s aftercare plan, they can receive a monthly dose of Vivitrol, in addition to attending follow-up medical and counseling appointments.

For more information on the use of Vivitrol:

• Visit the Vivitrol manufacturer’s website
• View Vivitrol use details for consumers
• Read articles about Vivitrol use on The Recovery Village’s site
• Read frequently asked questions about Vivitrol on The Recovery Village’s site

If you or someone you know struggles with an opioid or alcohol use disorder and could benefit from treatment with Vivitrol or other interventions, call The Recovery Village. Our network is ready to help you embrace recovery. We can help you find balance, restoration and a sustainable path forward from addiction.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Dr. Kevin Wandler, MD

Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more