Vivitrol, increasingly being tried by courts, prisons and jails across the United States to fight repeat heroin abuse, offers a long-lasting treatment option advocates say addresses the day-to-day struggle of recovering addicts. While Vivitrol and similar medications like Suboxone won’t prevent withdrawal or ensure sobriety, these drugs may curb the cravings or withdrawal symptoms that make recovery such a challenging journey for many addicts.
In fact, the potential benefits are so great that Gil Kerlikowske, who heads the White House Office of National Drug Control Policy, said that medications such as Vivitrol are the future of addiction treatment — which, until now, has relied almost exclusively on therapy-based models or addicting medications.
The National Institute on Drug Abuse (NIDA) is a strong supporter of medication therapy as part of an integrated addiction treatment program. According to the NIDA, medication may be used either to minimize withdrawal symptoms during detox or to help recovering addicts avoid the compulsive behavior that drives them to seek out drugs or alcohol. The NIDA notes that medication therapy may also:
- Increase patient retention in addiction treatment programs
- Decrease the rate of relapse among alcoholics or addicts in recovery
- Lower the rate of drug-related criminal activity
- Reduce the rate of drug-related disease transmission
As addicts try to create a new life free from drugs or alcohol, they need all the tools they can get your hands on. Medications like Vivitrol — which blocks the receptors in the brain that respond favorably to narcotic drugs or alcohol — aren’t intended to be a cure-all for alcoholism or drug addiction. These medications must be used as part of a treatment program that includes individual therapy, group therapy and medical supervision.
Despite increasing interest in Vivitrol, the public remains largely unaware of its potential to help recovering addicts stay sober. With that in mind, here are five things to know about the drug:
How It Works
Vivitrol uses monthly, extended-release injections of the opiate blocker naltrexone, which prevents heroin users from getting high. It’s an alternative to daily trips to methadone clinics, isn’t potentially addictive like other drug treatments and provides a buffer for recovering addicts.
“It’s very difficult to ask an opiate addict to adhere to a daily regimen of taking a pill that will reduce their addiction,” says Richard Pops, CEO of drugmaker Alkermes PLC. “The secret of Vivitrol, or its major contribution, is its once-a-month dosing format that actually provides a safety net for the patient.”
How Long It’s Been Around
A daily pill form of naltrexone had been tried before without significant success. The longer-lasting version was approved for alcoholism treatment in 2006 by the Food and Drug Administration, and Vivitrol was approved in 2010 for heroin, morphine and other opoid drugs. At the time, the FDA called it “a significant advancement in addiction treatment.”
Why It’s Being Used With Newly-Released Inmates
Heroin overdose deaths have soared across the country amid a surge in use of more widely available, cheaper heroin than before. Federal statistics show a 45 percent rise in heroin overdose deaths from 2006 to 2010. Studies have shown that fatal overdose rates are high among inmates newly released from correctional and treatment facilities because their bodies have been detoxified and can’t handle the same level of opiate as before. A Vivitrol injection gives them a month to resist their old urges and begin post-release counseling.
Potential Side Effects And Risks
Patients must be opioid-free when they start taking Vivitrol or could experience severe withdrawal symptoms. They should be aware that resuming drug use after stopping Vivitrol treatment could make them more susceptible to overdose.
There also can be severe reactions at the injection site, including tissue damage. Other potential side effects include liver damage, depressed mood and suicidal thoughts.
Why It’s Not More Widely Used
Although an estimated 2.5 million Americans are addicted to prescription painkillers or heroin, less than half are receiving a medical treatment and only a fraction are on Vivitrol. It’s relatively new, skeptics question its long-term efficiency and price — injections can cost $1,000 or more — and some doctors and officials are reluctant to use drugs to treat drug problems.
Pops, the drugmaker’s CEO, says the cost of heroin-linked crime, prison inmates and fatal overdoses is much steeper. “It’s extremely gratifying and at the same time extremely frustrating. It takes time.”
Initial evidence, though not conclusive, indicates that the drug may increase the chances of successful recovery, particularly for former inmates reentering society.
In 2010, researchers studied 64 participants from one St. Louis drug court along with two Michigan drug courts. Half were given Vivitrol and therapy, and the other half got therapy alone.
Vivitrol patients were about 57 percent less likely to miss drug court sessions. About 26 percent of non-Vivitrol clients were rearrested, compared to 8 percent of those who took Vivitrol, according to the Alkermes-funded study, which was published in the Journal of Substance Abuse Treatment in 2011.
Furthermore, the study estimated that keeping addicts from re-entering the criminal justice system saves between $4,000 to $12,000 per person after an initial arrest.
Still, many remain skeptical of the new drug.
Perhaps the greatest challenge for proponents of Vivitrol is that the use of medications to treat substance use represents a major paradigm shift in the addiction field. However, an increasing number of scientists and medical professionals are pushing for that shift, even in the face of resistance. To them, the potential benefits of medications like Vivitrol are too great to ignore.
“As long as we keep this on the outside of the mainstream of addiction treatment,” said Percy Menzies, who runs the St. Louis based Assisted Recovery Centers of America, “we’re not going to make any progress in this field.”
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