Vivitrol, a monthly injection of naltrexone, is making significant strides in helping addicts to stay clean from opioid drug dependence and addiction.
The drug, a long-acting formulation of naltrexone approved by The Food and Drug Administration (FDA) in 2010, blocks the brain’s opioid receptors so patients don’t feel a high when using an opioid drug. A key study conducted in Russia on 250 heroin addicts shows Vivitrol reduces relapses and narcotic cravings. About 86 percent of the patients taking Vivitrol were drug-free compared to 57 percent of those who received a placebo. Another study by the American Psychological Association shows similar results where 90 percent of patients on Vivitrol had opioid-free urine screens over a six-month period, compared with 35 percent on a placebo injection.
How Does Vivitrol Work?
Vivitrol is not addictive and does not have a black market like other anti-addiction drugs, such as methadone and buprenorphine. Methadone is an opioid agonist used as replacement therapy, and buprenorphine is a partial agonist that blocks most opioid receptors, while giving the patient a taste of opioid.
Both methadone and buprenorphine have to be taken daily, while Vivitrol is often a once-a-month injection. Dr. Phil Snolnick of the National Institute on Drug Abuse says Vivitrol makes a big change in the behavior for an opioid abuser:
“Someone who’s interested in not abusing opiates only has to make one good decision a month–or their family member has to make one good decision a month. That’s why it’s so important.”
How is Vivitrol Used?
Vivitrol is a shot of Naltrexone injected into a muscle. It is an extended-release medication of 380 mg every four weeks (or once a month) via intramuscular gluteal injection. The injectable form of Vivitrol can only be given by a doctor or nurse in a clinic.
Vivitrol can also be prescribed as a 50 mg once-a-day oral tablet, but there are downsides to taking the medication this way. With the injection, it is only administered once a month, whereas with a tablet you have to remember to take it everyday. Many health professionals highly recommend opioid drug addicts to take the injection instead of the oral tablet.
The drug maker, Alkermes, recommends users to go through a detox first. The injection will then block the brain’s opioid receptors, so if the user tries to get a high, they won’t feel it.
Vivitrol – A Response to the Rise of Opioid Drug Abuse
Vivitrol is one of many responses of the federal government to the escalating rise of opioid drug abuse in the United States. According to the Centers for Disease Control and Prevention (CDC), of the 21.5 million Americans age 12 or older that had a substance use disorder in 2014, 1.9 million had a substance use disorder involving prescription pain relievers and 586,000 had a substance use disorder involving heroin.
Fatal opioid overdoses are also on the rise, according to the CDC. The agency reports that in 2014, there was a total of 47,055 lethal drug overdoses. Opioid addiction is driving this epidemic with 18,893 overdose deaths related to prescription pain relievers and 10,574 overdose deaths related to heroin in 2014.
How Vivitrol is Helping Fight Opioid Dependence
Vivitrol was first approved by the FDA as a drug to treat alcohol dependence in 2006. The agency later approved the drug for opioid dependence in 2010 and the maker of Vivitrol, Alkermes, says there are now about 100 programs using it in 30 states.
Vermont is currently the only state that has approved the use of Vivitrol statewide. CBS News recently featured Vermont and its efforts to decrease the rates of opioid dependence.
Sales of Vivitrol have increased across the country since its approval to treat opioid dependence in 2010. Sales have increased from more than $18 million in 2009 to over $106 million in the first three quarters of 2015.
Alkermes CEO Richard Pops released a statement about Vivitrol, saying:
“It is gratifying to see the use of Vivitrol increasing across the country. It has taken time – Vivitrol is a new approach to treating opioid addiction and it requires new behaviors by physicians, counselors, nurses, and other elements of the treatment system. In many ways, the expansion of these programs has been somewhat organic, meaning that the success of one program in a particular country may spur another country to develop their own.”
Side Effects of Vivitrol
According to the FDA, there are some serious side effects that may occur from the administration of Vivitrol. One effect could be injection site reaction, which may cause liver damage and surgical intervention. Other side effects may include depression, suicide, and suicidal thoughts and behaviors.
The Cost of Vivitrol vs. Other Anti-Addiction Medications
Vivitrol is the most expensive anti-addiction treatment, but it is also considered the most effective. Here’s how the price of Vivitrol compares to other treatments for opioid abuse and addiction:
Vivitrol (Naltrexone shot): Opioid blocker. Not habit-forming. Non-controlled. Must be prescribed. Does not require waiver or registration with DEA. Monthly injection. Cost: About $1,000 per month (many private insurance companies cover some, if not all, of the cost)
Methadone: Opioid. Habit-forming. Controlled substance. Taken at specially licensed clinics. Daily pill. Cost: About $150 per month
Buprenorphine: Opioid. Habit-forming. Controlled substance. Must be prescribed by a doctor who receives a DEA waiver. Pill often taken every other day. Cost: About $300 per month.
Suboxone (Buprenorphine/naloxone): Daily film placed under tongue. Habit-forming. Controlled substance. Must be prescribed. Requires DEA waiver. Cost: About $450 per month.
Sources for Costs: Drugs.com; Darius Rastegar; John Hopkins School of Medicine; Alkermes; WashingtonPost.com
Vivitrol is not the End-All Solution for Opioid Abusers
The excitement about Vivitrol may overshadow the fact that it is not an end-all solution for people abusing opioid drugs. H. Westley Clark, a retired former director for the Substance Abuse and Mental Health Services Administration (SAMHSA) says:
“Naltrexone buys you a month, but if you stop taking it and you haven’t developed coping strategies you may relapse. People do recover from opioid dependencies, but often to do so they also need to deal with other issues in their lives.”
Vivitrol is only as effective as the patient is compliant. It is recommended that addicts receive counseling and therapy to deal with the issues that cause addiction. This will help you to develop coping strategies to prevent relapse.