- Addiction & recovery
Where to Get Vivitrol Shot?
October 11, 2021
Vivitrol is the brand name for the extended-release, injectable formulation of naltrexone approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). Vivitrol was formally approved as a medication for alcohol use disorder (MAUD) in 2006 and medication for opioid use disorder (MOUD) in 2010. Its active ingredient, naltrexone, is currently the only medication that isn’t a controlled substance. Vivitrol works as an opioid blocker by binding to the opioid receptors in the brain to help reduce the risk of relapses. It also blocks the endorphins from binding to their receptors to prevent the effects of alcohol as an AUD treatment.
Vivitrol belongs to the opioid antagonist class of medications. As such, it does not activate opioid receptors during treatment like an opioid agonist. It’s also non-addictive and non-narcotic and possesses a very low potential for misuse. Vivitrol is usually provided as part of a comprehensive treatment regimen that includes behavioral therapies and counseling.
How Is Vivitrol Administered?
Vivitrol is prepared and administered by a licensed healthcare provider in a clinical setting once every four weeks. It is injected into the gluteal muscle on one of the buttocks in a 380mg dosage. According to the FDA, Vivitrol should only be administered using the customized needle provided in the carton. The needle length may not be suitable for everyone due to body habitus. As such, most healthcare providers assess body habitus before each injection to ensure that the needle length is appropriate for intramuscular administration.
Healthcare providers may alternate between buttocks for subsequent injections throughout treatment in a procedure called rotating injection sites. This procedure helps reduce the possibility of scaring and injection site reactions due to receiving injections in the same place.
Vivitrol for MOUD treatment is only performed once an individual remains opioid-free for 7-14 days. However, Vivitrol for MAUD treatment can be administered to active alcohol users.
Where to Get Vivitrol Shot?
People can receive Vivitrol shots through any healthcare professional licensed to prescribe medications or through addiction specialists in inpatient or outpatient rehab settings as part of a comprehensive treatment plan.
People will be required to complete a specialty pharmacy form detailing their addiction condition and insurance coverage, if any, to receive Vivitrol. Once the specialty pharmacy confirms a person’s condition and insurance plan, it will coordinate with the person to deliver the first prescription to their primary care provider. The person will then be required to visit the clinic at the appointment date to receive their first dose of the medication.
Who Should Not Receive Vivitrol Treatment?
According to the American Psychological Association (APA), naltrexone-based medications are highly effective with a desirable pharmacological profile. However, they may not be the right treatment for everyone with an AUD or OUD. Hence people are advised against using Vivitrol if they are:
- Receiving opioid medications for any medical condition or have used opioid-containing medications or illicit opioids within the last 7-14 days.
- Currently experiencing a physiological dependence on opioids.
- Experiencing acute opioid withdrawal symptoms.
- Exhibiting hypersensitivity to naltrexone or any of Vivitrol’s ingredients.
- Diagnosed with severe liver disease or hepatitis.
People should also inform their doctors regarding the following before receiving Vivitrol treatment:
- Liver problems
- Bleeding problems or hemophilia
- Kidney problems
- Any other medical conditions
- Any other medications being taken, including prescription and non-prescription medicines, herbal supplements, or vitamins
- Pregnant or planning to become pregnant
It is unclear if Vivitrol can harm unborn babies or pass onto breast milk. However, oral forms of naltrexone have been observed to pass into breast milk. Thus, it’s important to seek medical advice to weigh the risks and benefits of the treatment. Certain practitioners may decide to administer Vivitrol to pregnant or breastfeeding mothers, depending on individual circumstances.
Side Effects of Vivitrol
Vivitrol can generate strong physical reactions in some people, while others may not experience any discomfort. People are advised to inform their doctors of any side effects that are highly uncomfortable or persist for a long time.
The most common side effects of Vivitrol include:
- Stomach pain
- Loss of appetite
- Increased thirst
- Painful joints
- Muscle pain
- Cold symptoms
- Depressed mood
- Injection site pain
People on Vivitrol treatment may experience severe injection site reactions. Some of such reactions, such as tissue death, may require surgery. As such, it’s important to contact your healthcare provider if you experience any of the below symptoms:
- Severe pain
- An open wound
- A dark scab
Vivitrol can also trigger pneumonia, a type of lung infection, and allergic reactions, such as chest pain, skin rash, and swelling of the face, mouth, and tongue in rare instances. These conditions are medical emergencies that require immediate medical attention.
Risks Associated With Vivitrol
One of the risks associated with Vivitrol use is the risk of an accidental opioid overdose. Since Vivitrol blocks the effects of opioids, individuals who try to overcome this blockade by consuming large doses of opioids can cause an opioid overdose that could lead to serious injury, coma, or even death. The risk of opioid overdose remains the same upon completing Vivitrol treatment due to reduced opioid tolerance during treatment. Opioid overdose is a medical emergency that requires immediate medical attention.
Vivitrol can provoke sudden opioid withdrawal syndrome (SOWS) when taken while there are opioids in the system. Sudden opioid withdrawals can be severe and may require hospitalization in certain instances. Hence, most healthcare professionals conduct a naloxone challenge test or urine test before treatment to test for any physical dependence on opioids. People who fail the naloxone challenge test or get a positive urine screen for opioids will not be eligible for Vivitrol treatment.
The active ingredient naltrexone can cause hepatitis or serious liver damage. Healthcare providers may stop the monthly injection when a person faces the following symptoms that indicate a liver dysfunction:
- Dark urine
- Yellowing of the whites of the eye
- Stomach pain that lasts for more than a few days
Accessing Vivitrol Treatment During the Covid-19 Crisis
The COVID-19 pandemic has changed how many things work in the current world. It has changed how people work, study, travel, and even shop for necessities. Most importantly, it has also changed how people access and receive medical treatment, especially addiction treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) has established new opioid treatment program (OTP) guidelines to reduce the spread and protect individuals in recovery.
As per the memorandum, doctors and clinics dispensing maintenance medications in areas under a state of emergency are authorized to dispense 28-days worth of medications for people deemed “stable” and up to 14-days worth of medications for people deemed “less stable.” However, people receiving monthly injections such as Vivitrol may have to talk to their healthcare providers to discuss how to receive care during the pandemic. In certain circumstances, oral naltrexone can be provided as a short-term measure between shots. However, it’s not highly recommended.
Co-pay assistance is available for eligible individuals to receive Vivitrol treatment during the pandemic. The U.S. Drug Enforcement Administration (DEA) has also eased restrictions allowing healthcare providers to conduct their initial evaluations and consultations virtually. However, the provider must be registered with the DEA to gain this opportunity.
Vivitrol is an effective tool for treating alcohol use disorder and opioid use disorder. However, it has to be used in conjunction with other elements of an addiction recovery program to establish long-term abstinence.
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