Recently there has been a sharp rise in the use of Vivitrol to treat opiate addiction here in the U.S.
Apparently the company that produces this drug has been able to go into places such as prisons and convince them to implement a program whereby people are offered a better deal in jail if they are willing to use this drug that helps prevent opiate relapse.
Because of this, the use of Vivitrol has exploded recently, but people are starting to notice some pretty significant side effects.
Vice says that “Vivitrol can cause depression and suicidal thoughts and may increase overdose death risk when people stop treatment,” and that “10 percent of patients reported depression, compared to 5 percent on placebo.”
The problem is that the medication blocks some of the chemicals in your brain that reward you and make you feel good, which in turn makes it so that you crave opiates or alcohol less. However, in some people this effect is creating something that resembles real depression, and in some cases even suicidal thoughts.
Then there is the increased risk of death by overdose, which is not a trivial amount in this case. This risk is even worse if you compare it to the alternatives for Vivitrol, which would include maintenance type medications such as Suboxone or Methadone.
In other words, if someone is taking Suboxone or Methadone in order to treat their opiate addiction, the risk of a fatal relapse is cut way down, because they are still getting some sort of opiate when they take their maintenance medication. However, if an opiate user goes on Vivitrol, they are not getting any additional opiates into their system, and therefore if they do relapse then they will be highly susceptible to overdose at that time. This is because their tolerance will have shifted massively while they were abstinent, but that individual is used to giving themselves a certain dose of opiates, which is going to be way too high following the use of Vivitrol.
It seems as if the world does not know enough about this medication and what the ramifications of the side effects are just yet. We have not had enough time and in depth studies performed to be able to know the full extent of the risks.
That said, anyone who has lost a friend or family member to an opiate overdose would argue that Vivitrol is probably safer than, say, shooting heroin.
But as more and more medications are developed to fight against addiction, maybe we need to take a step back and really measure some of these alternatives against each other in some clinical trials.
It is important to realize what is really going on when it comes to an opiate addiction in terms of the brain. When a person is putting an opiate substance into their body every day, what is really happening?
Take your average human being who is not currently on any drugs or addicted to anything at all. That average person has a certain amount of dopamine in their body right now that is very slowly being trickled into their system, each and every day.
So that the body has a baseline of dopamine that can then be further regulated and manipulated. For example, say that a woman is giving birth to a child, and her body is in a massive amount of pain. At that time, her body will naturally release extra dopamine in order to try to help the woman to cope with the pain. The same thing can happen in all sorts of different survival or “fight or flight” situations that human beings may encounter. Our body has that baseline of daily dopamine so that when we need an extra boost, a system is in place for our body to be able to deliver that boost.
Now realize that if a person were to take a medication such as Vicodin, or a street drug such as heroin, that would produce extra dopamine in the brain very quickly, and this is what produces the euphoric effect.
Over time, if the person continues to abuse opiates, the brain is eventually going to notice all of this extra dopamine and it will effectively say “OK, I can see that you are putting extra dopamine into my body every day, I can see that I no longer need to produce that daily trickle of dopamine that I normally make for you.”
And the body then shuts down its own dopamine production. At this point, the person has to keep taking Vicodin or heroin or some sort of opiate drug so that their body does not go into withdrawal. They are now hooked, because they abused opiates to the extent that their body stopped it’s own natural supply of dopamine.
At this point, they will go into withdrawal and feel very sick if they do not keep putting drugs into their body.
With a maintenance kind of medication such as Suboxone, a partial opiate molecule is delivered to the brain and it fills up the starving opiate receptors so that the body does not go into withdrawal, nor does the body crave “real” opiates.
With Methadone, those starving opiate receptors are filled up with a “real” opiate, or rather, a “full” opiate. Meaning that the person could take extra methadone and abuse it, getting a euphoric effect. Because of this abuse potential with Methadone, many people believe that Suboxone is the more sensible alternative. It calms cravings without the high amount of abuse potential.
Vivitrol is kind of a wild card, because while it seems to help reduce the cravings for opiates, it also seems to bring along some fairly risky side effects with it, some of which can ultimately be fatal.
So you need to discuss with your doctor, hopefully an addictionologist, what medication is right for your unique situation in terms of recovery.
And of course, the most important thing is to combine any MAT that you have with social support and real addiction treatment as well, such as at a 28 day program. Good luck!