There are certain courts of law here in the United States that have come to be known as “Vivitrol courts.”
Why? Because the judges of those courts are essentially offering criminals Vivitrol treatment as part of their sentence, and in some cases, you could make the argument that they are effectively forcing this on people.
NPR says that “…at least eight courts out of the several dozen in Indiana that say they only allow Vivitrol treatment.” That doesn’t leave many options for people, and you could argue that people are being forced on a certain medication.
So they judge may give someone an option of jail time or addiction treatment with probation, and the treatment would normally include several options. But the only option they are offering in this case is Vivitrol.
What is Vivitrol? It is a medication known as Naltrexone which blocks certain opiate receptors in the brain. This means that alcoholics using Naltrexone will have less heavy drinking days, and opiate addicts who use Vivitrol will have less cravings for their drug of choice.
It is not a perfect medicinal “cure” but it has been proven to help based on clinical trials.
However, there are alternative treatments for both alcoholism and opiate addiction, and those alternatives are not even presented as an option any more.
Why? Because the drug companies have campaigned to push their own product at the level of the court system.
Is this a good thing or a bad thing? Either way, this is the new reality. It is happening. So we have to make the best of the system that we find ourselves in, or we need to change the system.
Before you get too bent out of shape in regards to the fact that this medication is practically being forced on to struggling addicts, and the fact that they do not really get to choose which type of medication they use to assist them in treatment, let’s look a little bit closer at the real truth.
The truth is that we make it sound as if these medications that assist with addiction recovery are something similar to a real “cure,” when it fact they are far from it. In clinical studies these medications are shown to be more effective than a placebo, but that is only when combined with counseling and social support such as AA or NA meetings, and even then, the statistical significance of the “cure” is not that impressive.
Meaning that medications such as Suboxone or Vivitrol are not exactly the miracle cure that people hope they are.
This doesn’t really become a problem until we expect them to function like a miracle cure, which is actually pretty typical of most addicts and alcoholics who seek them out as their solution.
What do I mean by this?
There is a difference between the person who is in court or in rehab who says “I have heard about this Vivitrol and I want to use it to help me with my addiction” and someone who is assigned to a random study in which they are given an unknown pill that is supposed to help them while they go through treatment and therapy for addiction.
In the first case, the addict or alcoholic has heard about MAT (medication assisted treatment) and they want to try it for themselves. In the second case, a randomized study is done and people who are already planning on rehab along with counseling and therapy are given the chance to enter into a study in which they either get Vivitrol or a placebo.
In the first case, the addict is seeking out the MAT. In the second case, researchers are suggesting it to someone to see if they want to try it.
This, in my opinion, makes all the difference in the world.
If the addict or alcoholic is actively seeking out MAT as their solution, they are very likely to relapse. This is my opinion and it is merely based on my own subjective observations in the world. I have watched thousands of people go through the recovery process, and some of them sought out MAT and others did not. Of the people who I witnessed who were actively pursuing MAT as their solution, nearly all of them relapsed.
Again, my opinion here: I think they relapse because they have the wrong approach, the wrong attitude. They hear about a medication such as Vivitrol that can help reduce cravings, and they assume that in their case it will function as a cure. They believe this because they are a reasonably intelligent person who is normally very capable. So they think to themselves: “I am not like these other addicts and alcoholics because I am fairly smart, so if I just use this medication that helps with cravings, I should be fine.”
And so what really happens is that they talk themselves out of the hard work. The people who are giving them medications such as Vivitrol are saying “Make sure you stick with your meetings and your counseling and your therapy when you take this medicine, because it works alongside of those things in helping you to remain clean and sober.”
But the people who seek it out as a solution are playing a mental trick on themselves. Secretly, in the back of their mind, they are telling themselves that they will of course follow through with all of that treatment and therapy stuff, but in reality they are going to see if their cravings go away, and then it will be easy street. This is the secret thing that they are telling themselves, that they can just coast through their recovery as long as this medicine eliminates their cravings.
And this is why people set themselves up to fail. If a person is too eager to try MAT then my belief is that they are a very poor candidate for it. The face that they are drug seeking for a solution for their addiction means that they are looking for the easier, softer way.
These MAT solutions are not yet at the point where they can magically cure an addiction. We are just not there yet in terms of medical technology, and we may never get there. Addiction may continue to confound us and baffle as for decades to come. While MAT can be helpful to some people, those who seek it out the most adamantly are not the best candidates to benefit from it.
Again, that is mostly my own opinion based on casual observations, but I certainly stand by the ideas presented here. If MAT is to be effective then the counseling, meetings, social support, and rehab has to be the main priority, and MAT has to be a secondary solution. My 2 cents anyway.