For the best chance at long term recovery, treatment with Vivitrol for both alcohol and opioid addictions needs to be ongoing for an extended length of time on the recommended 28 day basis. Along with regular chemical dependency counseling and other recovery based programs, Vivitrol has a very high success rate with assisting patients in long term recovery. Treatment lengths for optimal results vary on a patient by patient basis, however one thing remains the same: one must be committed to extended lengths of treatment while engaging in a multi faceted recovery approach including complete abstinence, chemical dependency and/or mental health counseling , addressing underlying issues, establishing a sober support community, and behavioral modification efforts.
WHAT IS VIVITROL?
Vivitrol (extended release naltrexone) works by blocking the opioid receptors in the brain. These are the receptors that alcohol or opioids would otherwise attach to, then releasing the dopamine resulting in a rush of feel good feelings and euphoria. This temporary relief reinforces use of the drug, which eventually leads to addiction and physical dependence.
Vivitrol injections are used to prevent relapse in adults who became dependent on opioid medicine or alcohol following detox. Naltrexone can help keep you from feeling a “need” to use the opioid or alcohol by making the receptor feel “full”. Vivitrol injections last for approximately 28 days.
Vivitrol injection is also used to treat alcoholism by reducing your urge to drink alcohol. This may help you drink less or stop drinking altogether. You should not be drinking at the time you receive your first naltrexone injection. Furthermore, alcohol withdrawal can be fatal therefore it is never recommended to stop drinking “cold turkey” without first consulting with a physician.
Following detoxification of alcohol or opiates, once your mind and body are no longer being fueled with with opiates or alcohol, and after the pain and agony of acute withdrawal, one can expect the body to begin repairing itself to it’s natural physiological state. You will feel better; this usually will happen around 90 days of complete sobriety. Your mind will be clearer. You will have gained weight (or, lost it). You’ll be sleeping better. You likely will have improved in a lot of areas in your life. Your family will be proud of you. The world will be brighter. You will be feeling a way you haven’t felt in some time. This renewed sense of well-being does not mean that you are “cured”, therefore no longer in need of treatment with Vivitrol. This means that the medication is working, and has been doing exactly what it’s supposed to do: helping to prevent you from relapse and helping your body to natural recover. Stopping Vivitrol at this point (which happens so often I felt the need to write an entire blog discussing this topic), is not in your best interest and almost always results in cravings, and eventual relapse after skipping your injection. It may not happen immediately; you very well may continue on doing great and exactly as you have been, but sooner than later you will find yourself in a compromising situation with an old acquaintance, a stressful event, or a person tragedy occurs; it is at this very point that choosing to continue on Vivitrol will have made all the difference in the world.
This preconceived notion of well being should be reviewed and discussed with every patient who is intending to use an abstinence based treatment approach, and the benefits and risks of such a program weighted heavily based on a person’s individualized needs and life circumstances.
The nature of addiction tells you that you can have just one drink, or use just once, because you have made it this far. But one slip up most of the time takes you right back to where you once were. Sometimes immediately, sometimes gradually; but any person who has been unfortunate enough to understand addiction knows that it is a vicious (yet predictable) cycle. Getting onto Vivitrol, and committing to continuing it long term, no matter how well you are doing, is the most important decision you can choose to make when deciding that you truly want to recover, long term, once and for all.
It is also important to note that many overdose deaths occur when Vivitrol is discontinued prematurely or abruptly. Why? Decreased tolerance. A user uses the same amount of a substance once your body is no longer dependent on it. Or, drugs have evolved and are stronger and different than the last time you used. Or, people believe they are purchasing oxycontin, when in fact they are fake fentanyl pills. Overdose death percentage rates are also high in those being released from jail and inpatient rehabs for the same reasons. Some patients tend to feel that because they aren’t physically taking a pill every day that this medication may not be as effective or useful, which is not the case. Perhaps it’s not on their mind any longer, therefore the habit becomes a distant memory. It’s important to recognize the act of physically taking something to feel better (whether it be illicit substances, prescribed medications, or even the placebo effect) becomes a routine. Once you stop using illicit substances, and that habit disappears, the importance of the Vivitrol and its effects on you can be forgotten easily because you haven’t been physically taking it everyday. This can result in people feeling as though they don’t need it, or that it’s not important.
HOW LONG SHOULD I BE ON VIVITROL?
As a general guideline, anyone with a history of abusing opiates or alcohol should expect to be on Vivitrol for at least a year. This is a general good guideline to ensure you give yourself the time you need to truly leave the past in the past. You must change your people, places and things, establish healthy habits, address the underlying issues. This does not happen in 30, 60, 90 days. It takes time. Many patients utilize this medication for years at a time. Why? Because it works. There should be no shame in making a decision in a sound mind that is going to ensure you do not relapse; because you truly never know when your last use will in fact become your last use. If you do not continue your treatment with Vivitrol, there is nothing to help assist you with relapse prevention. If you never relapse while on Vivitrol, great! If you do relapse while on Vivitrol, you are protected. (Think of it this way: condoms don’t work if you don’t use them, but when they’re used properly you are protected. Same with Vivitrol.) If you do relapse after discontinuing Vivitrol, due to the nature of addiction, you’ll likely end up right back where you once were. There are very few risks that outweigh the benefits of Vivitrol injections, and you should talk with your provider regarding any reason you’d consider discontinuation to ensure you’re able to remain on the path of recovery versus potentially setting yourself up for repeating the cycle of addiction, or an overdose death due to decreased tolerance to opiates and alcohol.
Written by Stevie Nickole Duncan, Ohio Addiction and Recovery Consulting / Addiction, Recovery and Behavioral Health Specialist / Director of Operations /Practice Management North Dayton Addiction and Recovery Services and East Indiana Recovery. Stevie has over 10 years working in private practice specializing in addiction medicine, psychiatry, mental / behavioral health and wellness. She has made it her mission to provide information, education and experience to those seeking realistic options for long term recovery.