Vivitrol is a rather new treatment for alcohol abuse and addiction. The trials that got the FDA approval showed significant improvement over placebo in reducing drinking and/or helping to maintain sobriety. Vivitrol (naltrexone) is administered as an intramuscular injection once each month, and it is slowly absorbed into the bloodstream during that period. Naltrexone, the active medication, appears to help by reducing cravings for alcohol and reducing euphoria if alcohol is ingested. Naltrexone can be given orally daily to achieve the same effects. However, a patient may forget to take the naltrexone or choose not to take it for a day or longer and resume drinking. If taking an injection one time a month, the patient only has to make a decision once a month to get the benefits of that positive decision all of the next month.
Vivitrol may be free with the manufacturers discount for patients who have insurance. For those who don’t have insurance, the medication and the injection process is usually in the $600 range each month.
The patient needs to be under the care of a physician, preferably a specialist in alcohol addiction, who can order and manage the treatment and provide additional expertise in administering or referring the patient to a specialist in cognitive behavioral therapy. Cognitive behavioral therapy includes many formats such as one to one substance abuse counseling, 12 step meetings, working with a sponsor, and advocating changing one’s social life from drinking associates to recovering friends.
An addiction specialist can provide options to Vivitrol injection treatment if the patient prefers some other form of medication treatment or has side effects to Vivitrol. Options include oral naltrexone daily tablets, Campral, Topamax, or Antabuse. An addiction specialist who is also a psychiatrist is well prepared to evaluate and prescribe medication for potential co-occurring psychiatric conditions that may be contributing to the development and perpetuation of the alcohol problem. Bipolar patients have an eightfold risk of alcohol problems. Depressed patients have at least 8 twofold increase risk of alcohol problems. Anxiety disorders, ADHD, and drug abuse problems all increase the risk of alcohol problems. Patients who are properly diagnosed, treated with the appropriate medication, and improve psychiatrically have a significantly improved chance of getting away from alcohol.
If you would like to be evaluated for Vivitrol or another medicine to help reduce or stop drinking, call Atlanta psychiatrist Dr. Hege’s office today.