How Long Does the Vivitrol Shot Last?Anna Ciulla
While the opiate epidemic shows at least some signs of slowing, there are still millions of individuals locked in the grip of opiate addiction. According to the National Survey on Drug Use and Health (NSDUH), an estimated 1.7 million people had pain reliever use disorder, and 652,000 were diagnosed with heroin use disorder in 2017. In addition, alcohol use disorder (alcohol addiction) laid claim to an estimated 14.5 million people in 2017. Those seeking evidence-based treatment want results: relief from the incessant drug cravings and counseling to help them live a drug-free life with greater success in preventing relapse. Medication-assisted treatment (MAT) uses certain medications proven to help combat withdrawal symptoms and drug cravings as well as increase abstinence. Vivitrol is one of the medications used for this purpose. When you learn more about Vivitrol, including how long does the Vivitrol shot last, you’ll be better prepared to assist in your treatment and recovery from opiates and alcohol.
WHAT IS VIVITROL INJECTION?
Vivitrol injection is a medication containing naltrexone and is approved by the Food and Drug Administration (FDA) for the treatment of opioid addiction or opioid use disorder (OUD). It is also used in the treatment of alcohol use disorder (AUD). Vivitrol is a once-monthly treatment that is non-addictive and, as part of a treatment program that includes drug detox and counseling, has been proven effective to reduce relapse in alcohol- and opioid-dependent individuals.
While Vivitrol injection has no abuse potential, does not cause euphoria, and is non-addictive, it still must be used with care. While on Vivitrol treatment, you are advised not to use illicit or prescription opiates or drink alcohol.
HOW DOES VIVITROL WORK?
When treatment professionals administer Vivitrol, they are giving their clients medication that is designed to help them overcome dependence on opiates or alcohol.
When used to help treat alcoholism, Vivitrol decreases alcohol cravings by 90 percent, and blocks the euphoria or high from any alcohol consumed while on the medication, therefore eliminating the possibility of getting drunk.
Vivitrol works by blocking opioid receptors in the brain, paving the way for reduced cravings and increased abstinence – as long as the medication is used in conjunction with behavioral counseling and other therapies. That’s because medication alone is not enough to overcome dependence and addiction. Coupled with counseling and therapies, however, medication such as Vivitrol helps the newly-abstinent individual implement strategies and plans learned during treatment to lead a healthier, drug-free life.
A 2018 review in Addiction found that extended-release injectable naltrexone for OUD “appears to decrease opioid use but there are few experimental demonstrations of this effect.” Authors noted that many who intend to start Vivitrol treatment do not, while most who do wind up discontinuing treatment prematurely. Both factors, say the researchers, significantly limit Vivitrol’s clinical utility. Another study, published in the Journal of Substance Abuse Treatment, looking at unemployed, heroin-dependent individuals put into extended-release naltrexone treatment were more likely to complete the induction when they recently left longer-term opiate detox programs. Researchers said their analysis found that those on parole or probation were less likely to complete extended-release naltrexone induction and would likely need additional supports or modifications for the induction to be successful.
A long-term follow-up study published in the American Journal on Addiction found that, among community-based patients on naltrexone injection treatment for OUDs, outcomes were superior and with less relapse likelihood and greater time to relapse in spite of concurrent non-opioid substance use. Researchers noted that a majority of study participants discontinued treatment after “feeling cured,” and said additional guidance and motivational techniques might overcome this barrier. They noted also that few patients experienced any side effects or adverse events during long-term naltrexone injection treatment.
WHEN IS VIVITROL USED?
You can’t immediately begin a medication regimen with Vivitrol. When you’re dependent on or addicted to opiates or alcohol, rushing to take Vivitrol can bring on sudden opiate or alcohol withdrawal. Drug rehab professionals will only administer Vivitrol after the user has been free of opiates for a minimum of 1-2 weeks (7-14 days). As for alcohol, Vivitrol should only be provided to clients who are able to remain alcohol-free and are not drinking alcohol at the time MAT with Vivitrol is started.
In addition, according to Drugs.com, you should not take Vivitrol if you have used methadone or buprenorphine (Suboxone, Subutex, Butrans, Zubsolv) in the past 14 days.
Importantly, Vivitrol is only part of a multi-pronged and comprehensive treatment program tailored to meet the needs of the individual seeking to overcome dependence and addiction to opiates and alcohol. As such, Vivitrol is part of the MAT that accredited drug rehab facilities use and that has been effective helping people overcome drug and alcohol addiction.
HOW LONG DOES THE VIVITROL SHOT LAST?
Vivitrol injections last for one month. They are administered by injection into the muscle (intramuscular or IM) of the buttocks once monthly. Alternating the buttocks is recommended for subsequent injections. Vivitrol should not be injected subcutaneously (underneath the skin) or intravenously. Recommended dosage is 380 milligrams. Once injected, Vivitrol remains in the body and cannot be removed.
Since Vivitrol is a slow-release formulation, it is designed to last for a month’s time to block the effects of opiate medications and opiate street drugs. Vivitrol is also useful in treating alcoholism by reducing the urge to drink alcohol. A Vivitrol shot contains a diluted form of naltrexone, specifically designed for extended-release injectable suspension.
Some opiate-dependent individuals in treatment with Vivitrol, knowing the effects of the medication fade toward the end of the month may feel they can use opiates before their next Vivitrol injection with no ill consequence. Such deliberate action to defeat the opiate blocking effect of Vivitrol, however, can lead to opiate overdose which may result in death. Before medical professionals put their clients on a MAT with Vivitrol, these dangers are expressly detailed so the risks are clearly understood.
WHAT TO EXPECT WITH VIVITROL
Until you know how Vivitrol affects you, you should not drive or perform dangerous tasks, including operating machinery. You may become dizzy or sleepy after your Vivitrol injection. You may experience a number of common side effects, which may subside over time or can be addressed by your treatment provider. These include nausea, which is very common immediately after the initial Vivitrol injection, and typically disappears in a few days. Nausea is less likely after subsequent monthly injections. Other common Vivitrol side effects are headache, sleepiness, dizziness, decrease in appetite, joint pain, muscle cramps, toothache, cold symptoms, vomiting and sleep difficulties.
Depressed mood, however, is a serious possible Vivitrol side effect, which may lead to thoughts of suicide. Tell your medical provider immediately if you are in Vivitrol treatment and experience the following new or worsening symptoms of depression:
- Crying spells
- Always feeling sleepy or tired
- Sleeping much more or much less than usual
- Lack of interest in activities and friends you used to enjoy
- Feelings of hopelessness and helplessness
- Difficulty paying attention
- Changes in appetite (more or less hungry than usual)
- Noticeable weight changes
- New or increased feelings of anger, aggression, or irritability
- Thoughts of self-harm or suicide
WHAT IS SUDDEN OPIATE WITHDRAWAL AND WHEN DOES IT OCCUR?
While on a Vivitrol treatment regimen, if you take opiates (illicit or prescription), it can plunge you into sudden or precipitated opiate withdrawal. The opiate withdrawal symptoms most commonly experienced include body aches, chills, diarrhea, fever, goose bumps, irritability, restlessness, runny nose, shaking, sweating, vomiting, watery eyes, and yawning.
Immediately contact your doctor if you experience any of the following serious withdrawal symptoms:
- Weak, shallow breathing
- Severe dizziness
- Feeling like you’re going to pass out
- Thoughts of self-harm
- Severe pain, swelling, blistering, dark scab/lump where Vivitrol was injected
- Wheezing, new or worsening cough, trouble breathing
- Liver problems – including nausea, dark urine, clay-colored stools, jaundice, upper stomach pain, itching, fatigue, loss of appetite
IS THERE AN OPIOID OVERDOSE RISK WITH VIVITROL?
According to the drug manufacturer, there is a serious risk of opiate overdose when taking Vivitrol and using opiates – at the same levels as before you went into treatment. Some opiate users mistakenly believe that after detox and getting Vivitrol, they can go back to using without consequence. This can prove to be a fatal error, as using opiates and Vivitrol can lead to an accidental overdose, injuries, coma and death.
Vivitrol blocks the effects of exogenous opiates for about 28 days after administering the injection. However, as the effects wane and eventually completely dissipate, those who’ve been treated with Vivitrol “may respond to lower doses of opioids than previously used, just as they would have shortly after completing detoxification.”
If the individual uses opiate doses previously tolerated, this could result in “potentially life-threatening opioid intoxication (respiratory compromise or arrest, circulatory collapse, etc.).” Indeed, cases of fatal opiate overdose have been reported in individuals who used opiates at the end of their regular dosing interval, after missing a scheduled Vivitrol dose, or after stopping treatment.
Fatal overdose also can occur when those who’ve been treated with Vivitrol deliberately attempt to overcome the medication’s opioid blockade by taking large amounts of exogenous opiates.
For more about Vivitrol, painkiller addiction, detox and recovery, check out these articles:
Addiction to Oxycodone, Hydrocodone and Other Opiates: Warning Signs, Effects and Stats
How Long Does it Take for Opiates to Leave Your System?
How Long Does Precipitated Withdrawal Last?
Painkiller Addiction – What You Need to Know
- Addiction. “Extended-release injectable naltrexone for opioid use disorder: a systematic review.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29396985
- American Journal on Addiction. “Long-term follow-up study of community-based patients receiving XR-NTX for opioid use disorders.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28328148
- Behavioral Healthcare Executive. “Address the Opioid Use Crisis by Treating Depression.” Retrieved from https://www.behavioral.net/blog/s/ron-manderscheid/prescription-drug-abuse/address-opioid-use-crisis-treating-depression
- Clinical Neurology and Neurosurgery. “Headaches related to psychoactive substance use.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22424726
- Drugs.com. “Vivitrol.” Retrieved from https://www.drugs.com/vivitrol.html
- Journal of Substance Abuse Treatment. “Predictors of induction onto extended-release naltrexone among unemployed heroin-dependent adults.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28449955
- Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.” Retrieved from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report
- Vivitrol. “What Is Vivitrol?” Retrieved from https://www.vivitrol.com/opioid-dependence/what-is-vivitrol?cid=ds_bing_branded_sitelink%20-%20what%20is%20vivitrol&gclid=COvvmpqvguACFQ-FxQIdhG8Nig&gclsrc=ds