Addiction has become an exceedingly dangerous health crisis in America today. Tens of thousands of people die each year due to opioids alone while overdoses related to substance use disorders in general are higher than they’ve ever been, and are climbing fast.
In fact, the problem has gotten so bad that drug overdoses are now the leading cause of death for Americans under the age of 50.
Given just how extensive this problem has become, it’s especially exciting that a new study has found that Vivitrol, a non-opioid medication used in treating opioid dependency and alcoholism, can be just as effective in certain stages of recovery as products like Suboxone.
We’ll take a closer look at this study as well as what Vivitrol really is below.
What Is Vivitrol?
Vivitrol is an injectable extended-release formula of naltrexone, a pure opioid antagonist that helps block the euphoric and pleasurable effects of substances like opioids and alcohol.
Rather than helping patients cope with the withdrawal symptoms of detoxification, Vivitrol removes the incentives behind falling back into a system of abuse and also helps to reduce cravings at the same time.
As such, it can be particularly instrumental for someone who feels that opioids or alcohol is ruining their life but are afraid of relapsing during recovery.
Vivitrol also comes as a once-a-month injection, making it far easier to administer and keep track of than other medication-assisted treatments (MATs) that must be taken on a daily or weekly basis.
Naltrexone has long been considered to be inferior to other drugs in the treatment of opioid dependency. Methadone maintenance plans were the methods of choice for many doctors throughout the mid 20th century while buprenorphine has recently been recognized as the safer, more effective alternative.
With regards to alcoholism treatment, the National Institute on Alcohol Abuse and Alcoholism (NIAA) cite the benefits of using naltrexone as:
- Reducing a patient’s urge or desire to drink
- Helping patients remain abstinent
- Interfering with the patient’s desire to continue drinking more if he/she slips and has a drink
How Does Vivitrol Work with Opiate Addiction & Alcoholism?
When it comes to treating opioid addiction and alcoholism, Vivitrol has the perfect chemical structure to reduce cravings and remove the incentive of using again.
To explain, opioids and alcohol both act on specialized cells in the brain known as opioid receptors. These receptors are shaped in a specific way and only pair up with chemicals that have just the right physical framework – similar to a lock and key.
Once these two meet, the receptors set off a chain reaction that leads to a variety of effects in the body and brain including pain relief, euphoria, and sedation. For most people, feeling these effects is the main reason they abuse alcohol and opioids in the first place.
Vivitrol, however, is an opioid antagonist rather than an agonist like opioids and alcohol. That means that rather than binding with receptors and activating them, it just blocks them while keeping them inactive instead. That means that opioids simply cannot activate these cells unless there isn’t any naltrexone left in the area.
As such, users taking Vivitrol who try to get high off of these drugs will essentially be blocked from feeling the pleasurable effects (up to a certain point of course).
New Study Shows Vivitrol Just as Effective as Suboxone
A study released in November of 2017 found that despite how it has been viewed in the treatment community for so long, Vivitrol is actually just as effective at treating opioid addiction as such rehab poster boys like Suboxone (a combination of buprenorphine and naloxone).
In a relatively large-scale study funded by the National Institute on Drug Abuse (NIDA), researchers found that among the 570 opioid-dependent adults surveyed (between the ages of 25 and 45), the success rate of treating addiction with naltrexone was almost equal to that of Suboxone.
The three-year study was performed between 2014 and 2017 across eight community-based inpatient treatment facilities spread out over the United States. Researchers collected weekly urine samples and statements on the intensity of cravings and other side effects over a six-month period between two groups: one that was given Suboxone and another that was given Vivitrol.
The study found that at the end of the six-month period 56% of Suboxone users had relapsed. However, Vivitrol users had a lower rate of relapse at just 52%. While the difference isn’t earth shattering, it is still substantial.
What’s more, it shows that these treatment programs actually have a similar rate of recovery among opioid addicts – a fact that was hotly contested before the release of this study.
However, the problem of actually getting through the detox period required to take Vivitrol was too much to handle for many patients. As a result, the overall rate of successful recovery among Vivitrol patients was lower than those who used Suboxone.
Core Benefits of Vivitrol Over Suboxone: No Addictive Potential
One of the first question patients ask when learning about this treatment drug is “Is Vivitrol addictive?”
And it’s a fair question, especially since nearly every other drug used to treat addiction (especially to opioids) has at least some sort of potential for abuse or addictive quality.
But rest assured, Vivitrol has absolutely no addictive potential since it doesn’t even activate the opioid receptors in the first place.
That means using Vivitrol won’t lead to a naltrexone dependence or leave you with a painful and protracted Vivitrol withdrawal syndrome. Use of this drug can be maintained for an indefinite amount of time and won’t cause your body to build up a tolerance.
This, of course, is welcome news for many addiction sufferers. Horror stories abound in the addiction community about seeking treatment for one major addiction only to trade it off for another one that’s been prescribed during rehab.
However, it should be noted that while you can take Vivitrol for as long as you want, most doctors recommend that you maintain the treatment for at least a year to improve the chances of eventual recovery.
What’s more, Vivitrol should be used in conjunction with counseling, therapy, and other supplementary addiction treatments. Not only will these treatments give you the strategies you need to cope with life after Vivitrol, they will also help you get to the root of your dependence and enable you to overcome it.
Core Benefits of Vivitrol Over Suboxone: Access
Another one of the biggest benefits of using Vivitrol over Suboxone is the fact that it is much more accessible than buprenorphine products, at least in terms of regulations.
This point actually goes along with the fact that it doesn’t have the same addictive potential of Suboxone. Like methadone, buprenorphine providers must pass a number of federal checks and certification procedures in order to be able to prescribe this addictive opioid replacement therapy.
For example, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), buprenorphine providers must pass a specialized training program as well as receive certification from a SAMHSA-approved accrediting body.
What’s more, buprenorphine can only be administered as part of a comprehensive recovery program which includes medical, counseling, vocational, educational, and other assessment and treatment services as well.
Beyond that, physicians that prescribe Suboxone may only do so for up to 30 patients at a time in the first year after certification, making it sometimes difficult to find a doctor willing to take on more patients.
Like other regulatory guidelines for Suboxone, this 30-patient limit is meant to curb the abuse potential of the drug among prescribers and patients alike.
Vivitrol, on the other hand, has zero potential for abuse or dependency. As such, it does not have the same strict guidelines governing how it is administered. That being said, a single Vivitrol shot costs about $1000, so this price may be prohibitive by itself.
It’s worth remembering, however, that patients only take one shot per month.
A Few Issues with Vivitrol to Watch Out For
One problem to watch out for when it comes to using Vivitrol is that it can play a role in overdosing on opiates and alcohol.
When used properly, this shot helps block the euphoric effects of these two drugs. However, some people may try to overcome this barrier by taking more and more of these substances in order to try and feel a high.
However, Vivitrol does not block all of the effects of these drugs. As such, they can still be quite toxic at high levels and, according to the Food & Drug Administration, may lead to a potentially fatal overdose even though the individual doesn’t experience any euphoria.
The lack of intoxication, then, may lead some people to falsely believe they aren’t in danger of overdose.
Beyond the problem of trying to overcome the barrier that Vivitrol creates, the month-long dosage of this drug may also be problematic for some in that opioid tolerance drops quite rapidly after cessation. If an opioid-dependent Vivitrol user relapses and returns to using the same dosage after a long period of abstinence, it could end up causing a fatal overdose as well.
Precipitated Withdrawal from Vivitrol
One of the biggest setbacks for Vivitrol users, however, is the fact that it can and will bring on symptoms of precipitated withdrawal (which can be especially uncomfortable) if it is administered too soon in the recovery process.
To explain, Vivitrol is an opioid receptor antagonist and it has what’s called a “high affinity” for opioid receptors. Think of affinity as a kind of magnetism – the higher an affinity is for a type of a receptor, the more the compound will be drawn to it.
Drugs with higher affinities also tend to completely displace other compounds with lower affinities.
Vivitrol specifically has an especially high affinity. As such, when it enters an opioid-dependent system that still contains opioid molecules, Vivitrol comes in and bumps these opioids completely off of the receptors.
And since naltrexone doesn’t actually activate these receptors, the person is almost immediately launched into a state of withdrawal (known as precipitated withdrawal).
Most users want to avoid this state because it can be particularly painful. As such, it is imperative that you do not use opioids for a minimum of 7 to 10 days before taking Vivitrol.
How Does Precipitated Withdrawal Play into Vivitrol’s Effectiveness?
As it turns out, the fact that Vivitrol brings on precipitated withdrawal is one of the main reasons many practitioners still claim that buprenorphine and even methadone are superior to this drug.
The NIDA-sponsored study comparing the effectiveness of Vivitrol and Suboxone found that while the success rates of Vivitrol were higher among patients who actually began treatment with the drug, a significant number of patients could not get through the required detox portion.
In fact, only about 6% of the buprenorphine patients dropped out before starting treatment. The Vivitrol group, on the other hand, had a whopping 28% of patients drop out before medicated treatment began.
While it may be tempting to push aside these results in favor of a drug with so many benefits over Suboxone, it’s important to take into account all of the data points available when deciding on the most effective treatment method.
After all, a drug is only as effective as its entire program, not just one part of it.
However, these findings shouldn’t run through the addiction community without having any impact at all. Vivitrol is still clearly a reasonable alternative to buprenorphine should patients get through the withdrawals. And beyond that, it isn’t an opioid replacement therapy, making it much easier to cut out from your life permanently.
Side Effects of Vivitrol
While the benefits of Vivitrol are quite impressive when it comes to treating opiate and alcohol dependence, there are a number of side effects to watch out for when taking this medication.
According to MedlinePlus, the most common side effects of a Vivitrol injection may include:
- Stomach pain
- Decreased appetite
- Dry mouth
- Difficulty falling asleep or staying asleep
- Joint pain or stiffness
- Muscle cramps
- Tenderness, redness, bruising, or itching at the injection side
It is also possible to experience a few serious side effects of this medication. If you notice any of the symptoms below, call your doctor immediately.
- Pain, hardness, swelling, lumps, blisters, open wounds, or a dark scab at the injection site
- Shortness of breath
- Swelling of the eyes, face, mouth, lips, tongue, or throat
- Difficulty swallowing
- Chest pain
While overdose should not be a problem as shots are administered by certified professionals, human error could lead to injecting an improper amount. If you notice these symptoms, contact emergency services immediately.
- Stomach pain
Vivitrol: A Bright New Future for Addiction Treatment
The recent study by NIDA shows that we still have a long way to go in terms of finding the perfect addiction treatment method. While Vivitrol outperformed Suboxone in terms of general relapse rates, it still comes with the substantial hurdle of getting patients through the troublesome stages of withdrawal.
However, this study is still a step in the right direction. It’s never been more integral to our survival that new and effective addiction treatment methods like Vivitrol are discovered, documented, and tested at an exhaustive rate.