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Vivitrol: Helping People with Opiate Addiction

September 12, 2014  |  Falmouth Enterprise

Dr. Michael Bihari

What Is Vivitrol?

As prescription drug abuse and heroin addiction continues to be a high-profile problem in our community, local addiction experts say Vivitrol could offer an effective option for treating opiate dependence. Local law enforcement also recognizes the potential for reduced crime and reduced recidivism.

The active ingredient in Vivitrol — naltrexone — works as a “blocker.” It attaches to certain receptors in the brain and blocks the pleasurable feelings associated with taking opioids, such as prescription narcotic pain killers and heroin. Even though Vivitrol blocks the intense high from opioids, it does not prevent the good feelings that come from naturally pleasurable activities.  After getting a shot of Vivitrol, its blocking effect slowly decreases and completely goes away over time. The medication is given once every month, which may make it easier to stick with treatment, compared to other drugs that may require someone to take a daily pill.

Vivitrol does not alter mood, is not addictive, has no withdrawal symptoms when stopped, and has no street value. If you have an opioid addiction and use a narcotic painkiller or heroin while on Vivitrol, you will not get high, hopefully reducing your desire for those drugs.  Vivitrol is used as part of a Mediation Assisted Treatment program that includes an array of counseling and other types of therapy. A major drawback of Vivitrol is the cost, which can be about $1000 for each monthly dose. In Massachusetts, Vivitrol is covered by MassHealth and other health insurance plans.

Vivitrol is also used to treat alcohol dependence.

Barnstable County Correctional Facility Vivitrol Program

In April 2012, the Barnstable County Correctional Facility (BCCF) started offering Vivitrol treatment to inmates as part of a comprehensive pre-release program. BCCF was the first county correctional facility in the state, and one of the few in the country to offer this treatment. To date, BCCF has assisted six other counties in Massachusetts and has helped correctional facilities across the country to design and implement Vivitrol programs similar the one offered in Barnstable. With 100 inmates going through the BCCF program since 2012, it is the largest correctional facility Vivitrol treatment program in the U.S. 

Several inmates who have entered the BCCF Vivitrol program shared their history of drug abuse and why they volunteered for the program. The following is a compelling story about a 21 year old man who has been incarcerated in BCCF for 14 months for distributing crack cocaine, breaking and entering, and a probation violation on possession of a firearm. Prior to his arrest and sentencing he worked in a bakery.

His Family and Childhood: He lived with his mother and two sisters after his parents split up for the first time when he was five. His mother had a boyfriend who was physically abusive to him and he witnessed him sexually abusing his older sister. The boyfriend also abused his mother whose life he saved by calling the police during a particularly severe beating — he was six years old.

He hated his mother for not stopping the abuse but forgave her when he was 19. He credits maturity with his ability to forgive and understand that his mom was a person, making mistakes and doing the best she could. He also realizes that she was the only mother he was ever going to have and that he needed to love and appreciate her while she was around – they are now very close. He talked about getting revenge on his mom’s old boyfriend by beating him up and went so far as to use a phone app to locate him but something held him back. 

Drug Use and Criminal Activity: He began dealing crack cocaine at the age of 15 earning more than $15 thousand a month. His also started dealing in guns. He began using and selling “Perc 30’s” at age 19, which progressed to heroin when he was no longer able to obtain Percocet’s because his “supplier” went to jail. The gun dealing led to his arrest when someone who wanted to purchase a gun came to the deal wired with a camera.

Negative Consequences of His Drug Use: He has lost his children’s mother, his freedom and, most importantly one of his children was given up for adoption. He feels blessed that this child was adopted by a good family.

Why Vivitrol: He has had no previous substance abuse treatment. He does not want to use drugs and believes that Vivitrol will keep him from getting high. He does not see the point of using any drugs if he can’t get high.

Goals After Leaving BCCF:  He would like to go back to school  and get his GED. He plans to get involved with an organization in his community called “Youth Build,” similar to a tech school where academic work is combined with learning a trade. His long term goal is to attend a culinary arts school and one day own a bakery.

He said the “step to trading in old habits is getting new ones… if there is anything you are good at, make it a career, it doesn’t matter what it is as long as it is legal.” He talks to his mother about these things and she is able to get him to see the bigger picture and the consequences of what would happen if did not try to move forward.

What’s True and What’s Not

Addiction is a disease. Like diabetes, it cannot be cured, but it can be treated with medication such as Vivitrol, counseling, and support from your family and friends. Addiction is not a sign of weakness and it is not true that all you need to do the get rid of your addiction is to “be strong.”

The goal of medication-assisted treatment is to help you recover from addiction, not to replace one addictive drug with another. Providing a safe, controlled level of medication together with appropriate support can help you overcome the use of a problem opioid, either a prescription pain killer or heroin.

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