During the ongoing opioid epidemic, Vivitrol may just be the addiction recovery drug that America needs.
According to a new study published just this month in The Lancet, Vivitrol and Suboxone are equally effective at treating opioid dependence. This was the first American research to directly compare these two very different medications.
The implication is clear –both medications should be considered viable treatment options. A smaller Norwegian study published in October reached the same conclusion.
Because there is a sore need for evidence-based and effective treatment options for people struggling with Substance Use Disorders (SUDs) involving heroin or prescription painkillers, the results of these studies are a welcome bit of good news.
How Often is Vivitrol Given?
Vivitrol injections are formulated for extended-release, and only need to be administered once a month.
This is in direct contrast to the other top medications used for addiction recovery treatment.
Methadone must be taken every day. This typically involves a daily trip to the closest methadone clinic.
Because they are take-home prescriptions, buprenorphine drugs are considerably more convenient than methadone, but they still must be taken daily.
The once-a-month versus once-a-day distinction can be crucial to successful recovery. If a daily methadone/Suboxone dose is missed – at any point or for any reason – the patient may start suffering opioid withdrawal symptoms within a matter of hours.
The physical pain and mental anguish of opioid withdrawal can be so severe as to trigger a relapse – a return to active drug use.
Methadone and Suboxone Work Differently
It is important to note that, unlike methadone or buprenorphine drugs, Vivitrol is NOT an opioid. This has several benefits:
- Vivitrol is not addictive. The Substance Abuse and Mental Health Services Administration says that medications containing naltrexone have “no abuse and diversion potential.”
- Vivitrol does not produce a “high”.
- Vivitrol does not cause respiratory depression.
Methadone, on the other hand, is a powerful opioid that is a full agonist. Even though it is the best-known MAT medication used for opioid addiction recovery, methadone is extremely addictive in its own right. Methadone also presents an elevated risk of fatal overdose. In 2014, nearly 1 out of 4 opioid-related deaths involve methadone.
Likewise, Subutex, Suboxone, and other buprenorphine drugs are also synthetic opioids. However, they are classified as opioid partial agonists, presenting a lesser risk of divergence, addiction, and fatal overdose.
That does not mean that partial agonists are completely safe.
On the contrary, long-term buprenorphine use results in a physical dependency. As is the case with other opioids, the medication is discontinued abruptly, the user can quickly go to opioid withdrawal. Again, it is the discomfort of withdrawal that usually causes relapse.
How addictive are drugs like Subutex?
Up to one-third of people entering opioid rehab self-report having gotten high on buprenorphine within the previous month.
Even “abuse-deterrent” Suboxone is a popular drug of abuse. Opioid addicts often use Suboxone to stay functional in between heroin highs. In other words, they are using the medication to maintain their addiction.
One addiction expert in the St. Louis area, says, “…there’s more Suboxone on the street than in pharmacies. Most of the heroin dealers are diversified now. They offer you a choice of Suboxone and heroin. And now with all these generic forms coming out, that is going to explode.”
Vivitrol is The Most-Accessible MAT Drug
Even with all of the other advantages that it has over methadone and buprenorphine, the most favorable aspect of Vivitrol is its universal availability. Any physician who is licensed to dispense medications can prescribe Vivitrol injections.
This accessibility is completely different than the situations found with opioid MAT options.
Methadone is only dispensed at special clinics. In order to receive their daily dose of methadone, opioid addicts must commit a huge portion of their time and resources. Every single day, they must make a trip to the methadone clinic if they want to avoid getting “sick” – the addict’s term for opioid withdrawal.
For some, coming in every day can be a major obstacle, especially if they don’t have a vehicle or a driver’s license.
And if there’s no methadone clinic nearby – if they live in a rural area, for example – then merely difficult becomes impossible.
Finding a Subutex or Suboxone doctor can be even harder.
Although ANY physician can prescribe Vivitrol, that is not the case with buprenorphine medications. These drugs are so tightly regulated that a doctor must complete several hours of specialized training and then meet other licensing requirements in order to offer them to their patients.
And even when they meet those requirements, during the first year after certification, there is a strict limit on the number of opioid-dependent patients they can treat using buprenorphine – 30 patients at a time.
These very stringent extra requirements have created a shortage of buprenorphine doctors. Currently, less than 3% of American physicians prescribe buprenorphine.
How bad is the shortage?
About half of all US states and territories have less than 100 properly-certified physicians. This means that in some cases, a person might spend months on a waiting list. And, again, this problem is even greater in rural areas.
Why is This Evidence Supporting Vivitrol So Important?
For the last few years, every subsequent year has set a tragic new record for the number of lives lost due to fatal drug overdoses. Between 2014 and 2017, the number of drug deaths in this country has increased by 52%.
In the last two years, drugs have killed more Americans than the Korean and Vietnam Wars COMBINED.
The biggest factor in the increasing number of drug deaths is the ongoing – and worsening – opioid epidemic in America. 67% of all fatal overdoses are opioid-related.
To be even more specific, the opioid epidemic is being fueled by an explosion of overdose deaths involving either fentanyl or heroin.
In 2016 alone, these two dangerous opioids claimed the lives of almost 37,000 people in this country.
This clearly demonstrates that there is a critical need for more effective and evidence-based strategies that can be used to turn the tide of opioid abuse, addiction, and overdose.
There IS good news – these numerous studies ARE the evidentiary base that proves how effective is Vivitrol is at curbing opioid cravings and supporting a fully-abstinent lifestyle of recovery.