Dr. Cataldie's Corner

Vivitrol – my views

Vivitrol is an injectable form of naltrexone which is an opiate blocker. Naltrexone is also available in oral form. What exactly does “opiate blocker” mean? It means that if you are getting a Vivitrol injection once a month and you eat, snort, or shoot any opiate, you will not get high. There will be no euphoria. If there is no euphoria, you are less likely to put opiates into your body/brain. And, it might even numb some of the positive effects of alcohol so you might not enjoy drinking as much and therefore drink less or none. That’s the good news but we know for every action there is a reaction. According to the FDA, some of the side effects that can occur with naltrexone include nausea, tiredness, headache, dizziness, vomiting, decreased appetite, painful joints, and muscle cramps, reactions at the site of the injection, which can be severe and may require surgical intervention, liver damage, allergic reactions and allergic reactions. There is also the possibility of depressed mood and suicidality. Then there is the danger of trying to override the naltrexone by overdosing on opiates which can kill you. As with any medication that you put into your body, it is your responsibility and that of your prescriber to make sure you are fully informed about any medication you take. No matter what form you take of naltrexone it is not going to block benzos, hallucinogens, amphetamines, cocaine, synthetic marijuana, or marijuana. Indeed, a study in Psychopharmacology creates concern that naltrexone may enhance the subjective/mood effects of marijuana and worsen the cardiac effects of marijuana.

So what does all this mean? It means naltrexone is a useful tool for some people. It is not a magic bullet and is not held out to be one. It is not a stand alone treatment, which means the person needs to be involved in therapy. Addiction is a bio-psycho-socio-spiritual illness. Naltrexone can help with the biological component. Can it be a useful tool? Yes. For one thing, it can buy you some time away from the opiates or at least from the euphoric effects of the opiates. Is injectable naltrexone (Vivitrol) available at Woodlake? Yes.

To read and/or download the FDA Medication Guide for Vivitrol go this link:

http://www.fda.gov/downloads/Drugs/DrugSafety/UCM206669.pdf

Louis Cataldie, MD
Diplomate ABAM


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