Vivitrol: What is Vivitrol? How Does Vivitrol Work?

Clinical Reviewer

Vivitrol is used to treat drug and alcohol addiction. The medication is given as a shot by a medical professional once a month and helps prevent cravings.

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How does Vivitrol work?

Vivitrol blocks receptors in the brain to prevent the brain from sending signals craving for drugs or alcohol and to block the positive (“high”) effects if opioids or alcohol are used.

Vivitrol is not a cure for addiction and does not help with detox, but does make staying sober easier.

Because Vivitrol blocks and doesn’t activate receptors in the brain, it is not addictive and doesn’t cause withdrawal symptoms if stopped.

What is in Vivitrol?

Vivitrol contains the active ingredient naltrexone, an opioid antagonist. The recommended dose is 380mg every 4 weeks or once a month, usually injected into the side of the buttocks.

How does Vivitrol reduce cravings?

The fact that Vivitrol reduces cravings has been well-researched, but it’s not currently known exactly why.

There are likely several chemical responses at play. For example, one study suggests that naltrexone may reduce cravings by elevating cortisol levels. Cortisol helps to control mood and motivation.

However, psychology also plays a role. People are less likely to crave drugs or alcohol when they know they will not feel the positive effects.

What does Vivitrol block?

Vivitrol blocks opioid receptors in the brain. While alcohol doesn’t directly activate opioid receptors, research suggests a genetic variation in the mu-opioid receptor contributes to alcohol issues.

Simulation of Vivitrol Blocking Opioids in the Brain

Vivitrol blocking opioids in the brain

No, research shows Vivitrol does not reduce dopamine levels and is actually associated with a significant reduction of depression symptoms.

Yes, endogenous opioids are opioids that are naturally produced by the body and are considered endorphins. (Opioid drugs are chemically similar to these endorphins). Vivitrol blocks these endorphins from attaching to the opioid receptors.

Does Vivitrol help with pain?

Vivitrol isn’t a typical medication for pain relief.

Some studies show positive results of low-dose naltrexone for inflammatory and autoimmune conditions like fibromyalgia or multiple sclerosis. Though, these effects seem to be only at a low dose and are likely unrelated to the blocking of the opioid receptors. The research does not suggest that naltrexone is a good choice for a chronic pain patient addicted to opioid pain medications.

Is Vivitrol addictive?

No, Vivitrol is not addictive and does not cause withdrawal symptoms when stopped. 

It is overall well-tolerated with minimal side effects of Vivitrol and minimal drug interactions with Vivitrol.

Is Vivitrol considered a narcotic?

Vivitrol is not a narcotic, opioid or controlled substance. It doesn’t show on standard drug tests.

What are the alternatives to Vivitrol?

Naloxone is also available as a pill taken daily (brand names Revia and Depade). Vivitrol tends to be a better option because it eliminates the possibility of missing or skipping a dose.

Learn more about about addiction treatment options

Is there a generic for Vivitrol?

No, there is not currently a generic for Vivitrol. The drug patent doesn’t expire until October 2029.

Is Naloxone the same as Vivitrol?

No, naloxone is not the same as Vivitrol. Naloxone is used in the medication Narcan to reverse the effects of opioids during an overdose and is also used in Suboxone to prevent abuse. Naltrexone is the main ingredient in Vivitrol. The names sound similar but are completely different medications. 

Does Vivitrol work?

Yes, study-after-study demonstrates that those who include Vivitrol in their treatment are more likely to stay sober. The evidence is clear that Vivitrol produces reduced drug and alcohol use and reduced cravings compared to placebo with rather limited side effects.

What is Vivitrol's success rate?

The exact success rate number for Vivitrol depends on what study you look at and what counts as success. 

Is Vivitrol more effective than naltrexone?

Vivitrol is naltrexone given in the form of a monthly shot. Vivitrol would be just as effective as oral naltrexone if the pills were taken daily without missing or skipping a dose.

Where can I get a Vivitrol shot?

Vivitrol requires a prescription and usually isn’t given through an online provider or national chain pharmacy.

To get Vivitrol in Illinois or Texas, Symetria could be a good fit.

Symetria Vivitrol Doctors

To find a provider outside of these areas, the Vivitrol website has a provider finder directory.

How long do you have to wait before you get the Vivitrol shot?

Patients should be detoxed from alcohol and drugs before starting Vivitrol. For opioids, a minimum of 7-10 days free from opioids is recommended. For alcohol, 3-10 days is recommended.

Is Vivitrol covered by insurance?

Vivitrol is usually covered by insurance, including Medicare and Medicaid. The manufacturer also offers a co-pay program to help with any deductible costs.

Symetria doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

Gonzalez, J.P., Brogden, R.N. Naltrexone. Drugs 35, 192–213 (1988).

Johnson, B.A., Ait-Daoud, N., Aubin, H.-J., van den Brink, W., Guzzetta, R., Loewy, J., Silverman, B. and Ehrich, E. (2004), A Pilot Evaluation of the Safety and Tolerability of Repeat Dose Administration of Long-Acting Injectable Naltrexone (Vivitrex®) in Patients With Alcohol Dependence. Alcoholism: Clinical and Experimental Research, 28: 1356-1361.

O’Malley, S.S., Krishnan-Sarin, S., Farren, C. et al. Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo–pituitary–adrenocortical axis. Psychopharmacology 160, 19–29 (2002).

Oslin, D.W., Berrettini, W.H. and O’Brien, C.P. (2006), REVIEW: Targeting treatments for alcohol dependence: the pharmacogenetics of naltrexone. Addiction Biology, 11: 397-403.
Romach MK, Sellers EM, Somer GR, et al. Naltrexone in the treatment of alcohol dependence: a Canadian trial. The Canadian Journal of Clinical Pharmacology = Journal Canadien de Pharmacologie Clinique. 2002 ;9(3):130-136. PMID: 12422250.

Tarr, B., Launay, J., Benson, C. et al. ‘Naltrexone Blocks Endorphins Released when Dancing in Synchrony’. Adaptive Human Behavior and Physiology 3, 241–254 (2017).

Younger, J., Parkitny, L. & McLain, D. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol 33, 451–459 (2014).

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    1. I usually recommend at least 12 months. This is will allow enough time for the brain to heal, for counseling to work, and for positive environmental changes to take place. These are all key components for successful recovery. The evidence in the medical literature shows that patients who stop the Vivitrol less than 6 months after starting treatment are at a much higher likelihood of returning to their substance use.

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