‘Can Vivitrol really cure drug and alcohol addiction?’ (En)
Dr. Dave explains how alcoholics and addicts are beginning recovery with a monthly shot at their family physician’s office.
BILL: Doc, you ever run across Vivitrol in your therapeutic work?
DR. DAVE: It’s an extended release form of Naltrexone, and has been used to treat cravings in alcoholics for the last four years or so—the FDA just approved it for the same thing in heroin and other opiate drugs in 2010. What brings it up?
BILL: “I really thought I’d die of an overdose someday,” writes 24-year-old Amanda G. “Then I found out about Vivitrol. It really has stopped the cravings so I can stop obsessing about drugs and can focus on my recovery. If it weren’t for this, I don’t know if I’d be alive today.”
DR. DAVE: And you talked to the physician who prescribed her the drug?
BILL: “Vivitrol is the most important breakthrough in addiction treatment in the past 25 years,”says Dr. Frederick Hesse, Medical Director of Arms Acresin Carmel, NY. “It doesn’t just substitute one opioid for another as with ‘maintenance’ or ‘replacement’ treatments. My patients find it easier to remain sober because they only have to receive a treatment once a month as opposed to taking a pill each day. And with a clear head, they can focus on their recovery through counseling and 12 step programs. In the future, I believe we’ll look back and see how Vivitrol saved a lot of lives and helped deal with the opioid abuse epidemic.”
DR. DAVE: While agreeing with Dr. Hesse, having directed a Methadone Maintenance program, where we did substitute opiates while building a clean and sober lifestyle platform before completely detoxing the addict, I do see the benefit of those approaches too.
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BILL: I’m sorry, but I have never been a fan of putting addicts on another abusable drug like Methadone.
DR. DAVE: Here’s an interesting fact: The FDA found out that Vivitrol worked for heroin addicts from guess where? Russia. Programs tried Vivitrol instead and patients stayed off all opiates at twice the level as those taking a placebo. That led to our FDA approving it for doctors over here.
BILL: Then why don’t more programs for alcoholism and opiate addiction use Vivitrol, at least as another tool?
DR. DAVE: Two reasons, Bill. The first is belief that if an addict is given a “quick fix”, like the once-a-month Vivitrol shot, they may not do the more difficult work of modifying their overall lifestyle. Although it’s just a sample of less than 6, I have seen that happen in a few of my teenage patients on Vivitrol for alcoholism.
BILL: Come on, Dave! With adolescents, who’s to say they would have gone to group therapy or 12 Step Meetings if they hadn’t been on Vivitrol?
DR. DAVE: True enough; and the weeks they had clean before relapsing were all plus days in getting a taste of life without drugs. Actually, it’s the second issue that is the major problem—Vivitrol can cost $1,100 per shot and it’s so new that insurance carriers may not approve it.
BILL: But if there is hard evidence Vivitrol works, don’t you think they will start coming around?
DR. DAVE: The key to Vivitrol is combining it with a good family physician who will administer the drug monthly as long as the patient will start attending 12 Step Meetings. And yes, more and more insurance providers are covering at least part of the cost.
BILL: I’m aware these days that many doctors and nurses who have learned motivational interviewing methods, use that approach to nudge alcoholics and addicts into meetings. Ten or twenty years ago, I can hardly ever remember a newcomer saying their MD worked with them to get involved in AA or NA.
DR. DAVE: As a consumer service, Vivitrol has also set up a website where our readers or their physicians can find a Doctor in their area who has experience prescribing the medication or where they can get more information, by going to this web location Vivitrol providers.
BILL: ..AND for the skeptics among us who see pharmaceutical consumer services as BIGPharm marketing, you can find a board-certified Addiction Physician who can consult with your family physician on Vivitrol and all the other medical options here.