Once you’ve decided to live a life free from drugs and alcohol, you may want to consider asking a clinical professional about medication-assisted therapy as a part of your treatment. Some of the most common medications you may read about are Suboxone, Vivitrol, Antabuse, Methadone, and Campral. These medications can’t get you clean on their own, but they do help to curb cravings and lessen the adverse side effects of withdrawal symptoms that make a recovery so difficult. It’s important to find a medication that will adequately serve your needs while reducing the possibility of abuse.
The opioid crisis claimed the lives of more than 20,000 Americans in 2016. The drug Vivitrol was developed to address this growing problem concerning deaths from opioid overdose and abuse. Vivitrol is a drug that helps those recovering from addiction prevent relapse. It is an extended release, injectable form of naltrexone, which acts as an opiate antagonist. What this means is that it essentially blocks the effects of opioids on the brain. The FDA initially approved it in 2010 for treating addiction. Vivitrol was the first non-narcotic, non-addictive, extended release medication approved for this kind of treatment.
Medication Assisted Treatment Options
The FDA has approved a multitude of drugs suitable for treating substance dependency. These drugs work in different methods and should be tailored according to the needs of the patient. Additionally, some of the medications carry a risk for possible abuse due, such as Suboxone and Methadone. It is not recommended that you take these medications recreationally or without the proper clearance and instructions from a clinical professional experienced in addiction medicine.
This is an “agonist” drug that binds to the body’s opioid receptors and activates these receptors in the same manner that an opioid might. It is offered at many certified treatment facilities and is usually administered in liquid form for daily use. Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it allows people to recover from their addiction and to reclaim active and meaningful lives.
Suboxone is a combination of two different drugs: buprenorphine (an opioid activator) and naloxone (an opioid antagonist). This combination of opposing forces provides a way for addicts to gradually wean themselves off of their pre-existing addiction while minimizing the effects that full-on withdrawal would otherwise trigger. Suboxone is administered with a light film or pill and is indicated for the treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psycho-social support.
Vivitrol is an “antagonist” that binds to opioid receptors, but only blocks them, stopping the effect of other opioid drugs. It can be prescribed by any health care provider and is taken as either a daily pill or a monthly injection. If you have used opioids or opioid-containing medicines before taking Vivitrol, using opioids in amounts that you used before treatment could potentially lead to overdose and death.
Campral has been on the market since it was initially approved by the FDA in 2004 and is generally used to treat symptoms of alcohol withdrawal. Campral has been shown in clinical studies to be an effective tool for patients to achieve long-term sobriety from alcohol. It works by stimulating the GABA receptors in the brain, similar to benzodiazepines, while also subduing the NMDA receptors. This makes a withdrawal from alcohol easier to cope with, restoring the brain to a stable state.
AntabuseAntabuse is another medication for the treatment of alcohol withdrawal symptoms, but it works in very different methods. Antabuse was initially approved in the 1950’s to help those recovering from alcohol dependency to stay sober. The drug works by causing unpleasant side effects for anyone who consumes alcohol while on the medication. Within minutes of combining alcohol with Antabuse, the patient will experience headaches, vomiting, anxiety, nausea and generally adverse feelings.
How Does Vivitrol Work
Vivitrol, like all forms of naltrexone, works by blocking the opioid receptors within the brain. The medicine binds to these receptors like glue and remains on them, ensuring that no high is attainable from taking another opioid. This is in contrast to medications such as methadone and buprenorphine which enact a mild euphoria from using. The drug is administered in only one dose, 380 mg, and must be administered by a clinical professional. The shot is taken once a month, and acts on extended release over that period, continually delivering medication.
Before taking the drug, the patient must be opioid-free for a minimum of 7-10 days. The concentrations slowly decline a couple of weeks after injecting. The drug is used for alcohol and opioid dependence. However, it can be dangerous when patients are given Vivitrol but still attempt to get high on opioids or consume alcohol. This is because the blocking effect may lead to the patient overindulging to attain a high, which will only lead to serious injury or death.
Unlike methadone, Vivitrol is not a controlled substance, meaning it can’t be abused and there is no black market for it. It wasn’t until researchers created an injectable, long-acting version that clinical studies showed the drug’s promise. Vivitrol has been tested in a six-month double-blind study, where people who used Vivitrol with counseling to treat alcoholism had a more significant reduction in the number of relapses, and more time spent abstinent from alcohol.
Many side effects can occur from taking Vivitrol, and it isn’t the right drug for everyone. There significant risks associated with taking Vivitrol, such as risking a future overdose, or have a severe allergic reaction to the shot. There is also a range of minor adverse side effects to be aware of. These include but are not limited to:
- loss of appetite
- increased thirst
- muscle or joint aches
- sleep problems (insomnia)
- decreased sex drive
- difficulty having an orgasm
On average, 44 people in the United States die every day from an overdose on opioid painkillers prescribed by a doctor or illicitly diverted from medical purposes. These drugs include Morphine, Codeine, Vicodin, and Percocet, and they inhibit the mind’s sensations of pain by binding to opioid receptors in the body. With prolonged usage, anyone can develop a strong dependency on these drugs, making the possibility of undergoing withdrawal symptoms more likely when the drug stops being taken.
Naltrexone (Vivitrol) vs. Naloxone (Narcan)
Naltrexone and Naloxone are both used for the treatment of substance abuse. Both of these medications are opioid antagonists that prevent the user from achieving a high. The only difference lies in the timeframe they work. Naloxone, brand name Narcan, is used for short-term relief, generally to help reverse the effects of an overdose. Naltrexone is a longer-term opioid antagonist that usually takes a couple of hours to kick in. Naltrexone, brand name Vivitrol, is administered in the form of a large shot taken once a month.
Narcan is primarily used as an emergency shot to reverse the effects of an opioid overdose quickly. It typically comes in a home kit that is easy to unpack and use. Naloxone is a life-saving medicine that is usually carried by medical personnel and first responders and has been in circulation for the last 30 years.
The drug can be administered as either a shot or through a nasal spray. Its injectable form comes in varying quantities and is best given by someone who has training in giving shots. The drug is injected directly into the muscles at 1cc and should be accompanied by rescue breathing and continual monitoring. For a detailed explanation, read how to inject Naloxone.
In its nasal spray form, there are multiple components you will need to assemble that should be included within your kit. Follow the instructions and affix the nasal spray device to the person’s nostrils. Half of the dosage should be sprayed up each nostril. For detailed instructions, read how to administer Narcan
Whereas Narcan can quickly stop the effects of an overdose, Vivitrol should be used only for the long-term treatment of substance dependence. Naltrexone blocks the effects of both alcohol and opioids, ensuring that no high can be achieved from the drug. Studies have shown that the drug can be highly effective compared to cold turkey sobriety and helps reduce cravings for the user's drug of choice.
The drug is available through clinical professionals and comes in one dose of 380 mg. The patient is injected once a month, and the long-lasting effects of the drug should be enough to block the opioid receptors within the body for that duration. Patients must remain opioid and alcohol-free for a minimum of 7-10 days to take the drug. You can learn more about the dosage and administration of Vivitrol from their website.
Is Vivitrol Right For You
As with any recovery treatment medication, many scientists and psychiatrists caution against labeling Vivitrol as a magic bullet or overstating its efficacy. It’s not the sole factor that can decide the outcome of treatment. However, taking the shot monthly can be extremely helpful for those facing daily cravings for opioids or alcohol. In one study conducted over 6-months, patients were given monthly injections of Vivitrol along with counseling against a different group taking a placebo with counseling. Though many participants did drop out of treatment, 36% of those in the Vivitrol group succeeded in total abstinence from opioids, compared with 23% in those treated with a placebo injection.
Vivitrol can help but is not the sole solution. It takes enrolling in an accredited rehabilitation facility, with rehabilitation programs that combine counseling, psycho-therapeutic work, and medication to help a person move forward in their recovery process.
Vivitrol vs. Suboxone
The most extensive study comparing the efficacy of both Suboxone (buprenorphine and naloxone) and Vivitrol was conducted from 2014 to 2017 at eight inpatient treatment facilities across the country. 570 opioid-addicted patients were administered either drug, and their progress was tracked. The results showed that both drugs were promising for long-term treatment, with about half of each population reaching and maintaining sobriety for the three years.
However, there were a number of caveats that showed drawbacks to each. For one, more patients who were given Vivitrol gave up treatment before the study began. Roughly 28% of patients given Vivitrol could not make it through the detox period required to start the drug, which was three days in the study. This is compared to 6% for those who began Suboxone, which has no detox period required. For those at highest risk for relapse, this could indicate that Suboxone is the better treatment option. Overall, Suboxone also had a slightly better success rate in the long term, 56% compared to 52% reaching sobriety.
Another caveat is that Suboxone can be used to achieve a mild euphoria, and is even sold on the streets. Suboxone may not receive the same level of funding or support because it is seen as replacing one hard drug with a lesser form. However, since both drugs had a roughly 50% success rate, both should be seen as viable treatment options that should be prescribed according to the patient’s needs.
For example, if someone has a severe opioid addiction, they may require Suboxone because of the painful withdrawal symptoms. The same goes for someone who started taking opioids because of chronic pain. They may need some lesser form of pain-killing medication merely to function. However, if someone lives in a rural area without quick access to a clinic, Vivitrol may be more helpful because the shot only needs to be taken once a month.
As with any medication-assisted treatment, Vivitrol is most effective when combined with a long-term program for sobriety. Inpatient treatment centers will commonly prescribe Vivitrol to those suffering from opioid dependence to give them a better chance of recovery. Likewise, continued therapy and participation in abstinence meetings will help the patient to receive all the benefits of this drug.
At Landmark Recovery, we believe in holistic treatment that combines leading therapeutic models, long-term drug and alcohol recovery programs, and clinically tested medication to give the best possible chances of recovery for our patients. With the right support behind you, you can live the life you dreamed.