Naltrexone (Vivitrol) Treatment for Opioid Addiction

Naltrexone, better known as Vivitrol, is a form of medication-assisted treatment used to help individuals recover from heroin and opioid addictions. It blocks the effects of opioids, and helps prevent relapse. Naltrexone should not be used within 7 to 10 days after using opioids, because of a potentially dangerous interaction.

What Is Naltrexone (Vivitrol)?

Naltrexone is a synthetic opioid antagonist. It’s prescribed to block opioids from binding to their receptors, and decreases the urge to use prescription or illegal opioid drugs by preventing the euphoric effects they produce—it also may be used to reverse the effects of opioid overdose. Naltrexone is the generic ingredient in Vivitrol, ReVia, and Depade.

Vivitrol is a 380mg shot which is injected into the buttocks by a medical professional once a month. Naltrexone also comes in a 50mg pill known as ReVia and Depade, which are to be taken every 1 to 3 days.

Naltrexone may not work for everyone, but one of the important things to remember about naltrexone is that it can precipitate opioid withdrawals. Each patient should avoid taking opioids for 7 to 10 days before starting naltrexone treatment.

Detoxing From Heroin And Prescription Opioids

Most people who become physically addicted to opioids will experience withdrawal symptoms when they quit. These might include abdominal pain, hallucinations, sweating, generalized anxiety, or tremor. That’s because when a person stops using an opioid they’re brain sends a surge of adrenaline through their body, causing these symptoms.

Opioid withdrawals are difficult to manage alone. In a medical detox, all of these side effects and symptoms of opioid withdrawal will be monitored.

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A medical detoxification is the safest way to cope with opioid withdrawal. It gives patients in early abstinence the help they need. The sad reality is that if left untreated, withdrawal symptoms can be dangerous, and even life-threatening.

How Does Naltrexone Help Treat An Opioid Addiction?

Opioids are among the most addictive drugs in the United States—so much that they’re considered part of an opioid epidemic. From 1999 to 2015, prescription opioids claimed the lives of 183,000 people in the US alone. Sadly, the majority of those people were unable to quit, because they didn’t have help. Medicines like naltrexone can help with treatment, and ensure that recovery is possible.

Naltrexone is used to prevent relapse, and maintain abstinence, but only after a person completely withdrawals from opioids. It works by antagonizing the opioid receptors, and blocking the euphoric and sedative effects of drugs like heroin, morphine, oxycodone, hydrocodone, and fentanyl.

Naltrexone has been approved by the Food and Drug Administration for treatment of opioid use disorders and alcohol use disorders, but taking it by itself isn’t considered a full treatment. There are several equally important parts of a medication-assisted treatment, which include:

  • Medication
  • Counseling sessions
  • Support group meetings
  • Education programs
  • Behavioral therapies
  • Lifestyle changes

How Is Naltrexone Administered?

Naltrexone is administered for patients who are highly motivated to stay in recovery. Doctors start them off with a low dose of naltrexone (Vivitrol, ReVia, or Depade) to be sure that they don’t have a negative reaction to it. After that, the dose will be increased as needed.

It’s important to take doses exactly as prescribed, and to schedule monthly appointments for Vivitrol injection. Naltrexone can be prescribed by any healthcare professional who’s licensed to prescribe medication. Nonetheless, it needs to be used as part of a comprehensive treatment program.

“You may take naltrexone for days, months, or years—as long as it is needed to prevent relapse. However, you should be checked often by your doctor if you have liver disease,” (Substance Abuse and Mental Health Services Administration – SAMHSA).

Naltrexone may cause liver damage, so clients undergo blood tests before beginning treatment. Throughout treatment, this test is repeated to determine how the drug affects each patient, and to ensure patients’ safety.

Can Naltrexone Be Abused?

Fortunately naltrexone has no abuse potential, causes no euphoria, nor is it considered addictive, however it still needs to be used with care. Patients are advised not to use illicit opioids, prescription opioids, or alcohol during naltrexone treatment.

Naltrexone “works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings,” (SAMHSA).

Side Effects Of Naltrexone

Naltrexone may cause side-effects, but one of the biggest problems with naltrexone is poor compliance—or not following the guidelines for use. If you use an opioid during naltrexone treatment, it may result in serious injury, coma, or death.

Sometimes a person will experience side-effects from naltrexone; whether it’s taking too much, having an allergic reaction, or combining dangerous drug interactions. Therefore it’s important to be completely honest with a doctor, before starting treatment.

Some of the most common side-effects of naltrexone are:

  • Nausea
  • Diarrhea
  • Headache
  • Nervousness
  • Sleep problems
  • Tiredness
  • Joint or muscle pain
  • Injection site reactions
  • Allergic pneumonia
  • Liver injury

Naltrexone Interactions

As previously mentioned, naltrexone may have a negative reaction with certain illegal, prescription, and over the counter (OTC) drugs. These reactions may include nausea, headache, dizziness, diarrhea, coma, or death. These substances may include:

  • Heroin
  • Fentanyl
  • Hydrocodone
  • Oxycodone
  • Morphine
  • Alcohol
  • Tranquilizers
  • Sedatives
  • Cold and cough medicines
  • Diarrhea medicine
  • Disulfiram
  • Thioridazine

A person using naltrexone may have a reduced tolerance to opioids, and also may be unaware of their potential sensitivity to the same, or lower doses that they used to take. If you relapse, taking the same amount of an opioid as when you quit can increase the chance of overdose.

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Other Uses For Naltrexone

Naltrexone is also used to help people overcome alcohol use disorders. Long-term naltrexone therapy exceeding 90 days is considered to be the most effective to treat alcohol dependence. According to the U.S. National Library of Medicine, low-doses naltrexone may work as a novel anti-inflammatory for treatment of fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome.

How To Start Taking Naltrexone

Naltrexone can be administered by any medical professional licensed to prescribe drugs. It’s best used after a medical detox, and often paired with an inpatient treatment program. It can also be used as a part of outpatient drug treatment.

With the help of naltrexone, counseling, and support people are able to recover from opioid use disorders, and live a full and happy life. Naltrexone isn’t right for everyone, but it may be right for you.


Center for Disease Control and Prevention – Prescription Drug Overdose

Substance Abuse and Mental Health Services Administration – Naltrexone

Substance Abuse and Mental Health Services Administration – The Facts About Naltrexone


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