The girl I met in the Heroin Anonymous was as pale and beautiful as a moonbeam. I could almost see through her. She was newly out of treatment, with 90 days of sobriety. Her front teeth were still chipped and damaged from smoking crack, and as we talked, she pointed to the scars and craters on her arms and upper thighs where infected abscesses had eaten her flesh. She said she was feeling better, clearer, and she was glad to be sober.
“How’s your day-to-day stuff?” I asked. “Are you worried about relapsing?” She gently shook her head and looked down. “I’m on the shot,” she told me. “I miss heroin, but I don’t crave it. I have a whole year of Vivitrol, prescribed.”
That was the first time I’d heard of Vivitrol, a powerful opiate blocker that is used to treat heroin addiction. The drug, which is generically labeled naltrexone, is an extended-release injectable medication that can dull or completely erase cravings for opiates for up to 30 days. For addicts who suffer from both psychological and physical dependency, Vivitrol can offer a welcome reprieve from cravings. However, like any medication, it’s not perfect and can’t guarantee permanent sobriety.
What Does Vivitrol Do For Heroin Addicts?
Naltrexone is a medication that reduces the desire to use opiates and alcohol. Unlike methadone, another commonly used medication for heroin addicts who are trying to kick the habit, Vivitrol is not habit forming and is not a “substitute” for the addict’s substance of choice. The shot is administered once a month by a medical professional and is effective for up to 30 days. Ideally, Vivitrol gives a heroin addict a better chance at maintaining their abstinence and therefore developing a solid base for their recovery. For addicts who have tried everything, including cold turkey withdrawal, short term detox programs, treatment, and other methods, Vivitrol might be the missing piece in addiction’s puzzle.
The FDA recently approved Vivitrol for the treatment of alcohol addiction, as well. Unlike Anabuse, Vivitrol doesn’t make the addict violently sick if they drink or use. Instead, the person feels nothing—no buzz, no intoxication, and no high. According to the National Institute on Alcohol Abuse and Alcoholism, “Naltrexone can interfere with the patient’s desire to continue drinking more if he/she slips and has a drink.” The overwhelming craving is gone. It’s possible to relapse while on Vivitrol—I have met several heroin addicts who continued trying to use, even though they were on the shot. However, taking the physical craving out of the picture makes it easier to focus on what’s triggering the addictive behavior and treat the disorder instead of its symptoms.
There Is No Cure for Substance Addiction Disorder
Vivitrol is a relatively new medication. The FDA approved it for use in treating heroin addiction in 2010. Although some people touted it as a “miracle drug,” the fact is that there’s still no cure for substance addiction disorder. Vivitrol by itself isn’t enough to ensure lasting sobriety. Its physical side effects—such as nausea, mild depression, and headaches—are very mild, but the biggest psychological drawback is the idea that the shot is a “cure” for heroin addiction.
Although Vivitrol is extremely effective, it’s not an insurance policy and it’s not a guarantee that the addict won’t relapse. The medication puts a stop to opiate and alcohol cravings, long enough to give the addict a chance to seek help and start getting their life back together. Anecdotally, the injection doesn’t stay effective for a full 30 days. For some addicts, the medication wore off after 3 weeks, and they used their next scheduled Vivitrol shot. No medication is perfect, and keeping that in mind is crucial to branching out in recovery.
Vivitrol is a safety net, not an insurance policy. It’s designed for people who are ready to stop drinking and using completely and works very well for addicts who are willing to make big changes in recovery. One study found that people on Vivitrol who also went to AA or other 12-Step groups had a better outcome than those who relied on the medication alone. Although AA may not be for everyone, finding a support group or recovery community, and learning to live without heroin is critical for maintaining long-term recovery.
Is Vivitrol a Cure or a Crutch for Heroin Addicts?
As any addict can tell you, a substance is just a substance. By itself, Vivitrol does what it’s designed to do: give heroin addicts and alcoholics a break from the horrible cravings that keep many addicts locked in the cycle of substance abuse. However, it’s not a cure for addiction and won’t make an addict’s crazy thinking go away. As people in recovery say, “The monkey’s off your back, but the circus is still in town.” Addicts and alcoholics who want more than just a month or two off from cravings need to work on the “circus” part of their addiction, too.
Three years later, the girl I met in Heroin Anonymous is still sober. She’s still luminous, sweet, and compassionate. She no longer uses Vivitrol—after a year of monthly medication, she took the leap of faith and started relying on the other parts of her recovery to keep her sober. It’s working for her. Vivitrol gave her the safety net she needed until she realized that, with time and support in recovery, she was ready to fly.