According to the CDC’s 12 Month-ending Provisional Number of Drug Overdose Deaths by Drug or Drug Class, 48,000 people died from opioid overdoses in 2017. While inpatient and outpatient therapy, behavioral therapy and support groups are key to recovery from opioid addiction, researchers are searching for medications to help with overdose reversal and treatment. Unfortunately this has some policy makers moving away from proven treatments towards unproven medications, lobbied for by lobbyists.
One of the prescription medications used to treat opioid addiction is Vivitrol, the brand name for naltrexone, an extended release injectable suspension. Unlike other forms of naltrexone which must be taken once a day or three times a week, one injection of Vivitrol lasts a month. Vivitrol is a synthetic opioid antagonist, meaning it blocks opioids from binding to their receptors, so users don’t feel euphoria and the other effects. It’s been used for years to reverse opioid overdose and treat opioid addiction. The idea is if you use a drug and never feel any of its effects, eventually the cravings and positive feelings associated with the drug use will fade and you won’t feel the need to use it.
Tom Price, President Trump’s former Health and Human Services Secretary (who resigned in scandal in September 2017) upset addiction experts by saying he didn’t believe in maintenance therapies like methadone and buprenorphine, saying it was like trading one opioid addiction for another. After visiting an Ohio pharmaceutical factory where Vivitrol is made he praised the medication saying it could cure addiction. While medication assisted therapies have a long history of success in treatment, naltrexone has not been studied as much and has some serious side effects.
Some people who have taken Vivitrol have reported not feeling anything at all. In an interview with Vice one opioid addict said she felt depressed, disillusioned and uninterested in things she used to enjoy. She barely ate, didn’t talk to people and couldn’t sleep. The medication label says it can cause depression and suicidal thoughts and may increase overdose death risk when people stop treatment.
There have been a few small studies – mostly industry funded – that show Vivitrol works. This may be true but only if people continue to use it. Despite the manufacturers calling the monthly shots an incentive, one study of 1,900 patients being treated for opioid or alcohol addiction found 39% accepted just one shot and 14% took five or more.
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