Vivitrol is time-release formulation of naltrexone that is administered once a month via injection. It is an opioid antagonist, which means it binds strongly to opioid receptors, preventing opioid drugs from having any effect. Whereas other opioid treatment medications such as buprenorphine or methadone function as weak opioids, that reduce withdrawal symptoms and cravings while allowing recovering addicts to function more normally, Vivitrol simply renders opioids inactive for as long as the drug remains in your system. The logic is that if opioids no longer affect you, you won’t want to use them.
Vivitrol has shown some success as a treatment for opioid addiction, but it has also provoked some controversy. It was approved by the US Food and Drug Administration, or FDA, on the basis of one small study conducted in Russia. Furthermore the drug has been heavily marketed toward drug court judges and corrections officials as a way to keep drug offenders clean without giving them access to drugs like methadone, which have potential for abuse. Consequently, drug offenders are sometimes given Vivitrol injections before being released. Critics have claimed that this punishes drug users unfairly because Vivitrol doesn’t prevent cravings like methadone or buprenorphine and it may put users at a higher risk for overdose.
A new study suggests the fear of increased overdose rates might be justified. Previous studies have found that Vivitrol does, in fact reduce relapse rates. One study found that it even performs slightly better than Suboxone, the sublingual form of buprenorphine. The study found that 56 percent of people taking Suboxone relapsed, compared to only 52 percent of people taking Vivitrol. There was one huge caveat to the study though: While only six percent of people dropped out of the Suboxone group, more than 25 percent dropped out of the Vivitrol group before even taking the first dose. The reason appears to be that you have to detox completely from opioids before starting Vivitrol injections to prevent rapid detox, while Suboxone can be taken much sooner, relieving some of the strain of detox.
The question is, what happens to the people who quit Vivitrol. The new study published in the journal Drug Safety tried to answer this question by reviewing the deaths of patients who had been taking Vivitrol. Of the 263 ‘adverse events’ reported to the FDA, 10 were suicides, 52 were overdoses, and the rest were undetermined. Of the 52 overdose deaths, five were cases where people tried to override the effect of the Vivitrol by taking high doses of opioids. Most overdose deaths occurred only a few weeks after the last dose of Vivitrol had worn off. The study does not show conclusively that Vivitrol injections put people at a higher risk of fatal overdose, but it does suggest a need for better follow-up study. The data for this study relied on information reported by the drug maker, Alkermes, to the FDA and fewer than a quarter of ‘adverse events’ were accounted for.
Opioid relapse is extremely dangerous because it typically comes when cravings are high and tolerance is low. Someone who has been clean for a month or two cannot resume using at her usual dose without risking overdose. When Vivitrol is administered without therapeutic support, especially if it’s against the user’s will, it essentially creates perfect conditions for overdose.
Located in downtown Midland, The Springboard Center’s mission is to offer programs and services to treat alcohol and drug addiction treatment using an evidence based curriculum, 12 step programs, diet, nutrition, exercise, emotional, mental and spiritual development for a long recovery. For more information, please call us at 432-620-0255 as we are open 24 hours a day, 7 days a week.
