Author: Dr. Norman Johnson, CEO

The generic name of Vivitrol is naltrexone. Naltrexone has been around for decades and is known as an opiate antagonist, which means that it blocks the effect of opiates. Therefore, if you have taken Vivitrol you will not get the opiate euphoria that comes with heroin or illicit use of prescription pain medication. Recently there has been increased sensitivity to the number of opiate deaths that occurred because of overprescribing of narcotics and lack of physician knowledge of the risk and dangers of narcotic use for non-cancer pain. Because of this, there are many programs now funded by government sources that are working through the public health department to expand the use of Vivitrol to help prevent ongoing use of opiates.

My opinion of Vivitrol is that it works in the opiate-addicted patient to help diminish or eliminate opiate-seeking behavior by blocking the euphoria that comes with addiction to opiates. However, the long-term benefit appears to be low and that comes from poor compliance. Compliance depends on the motivation of an individual. Over a period of time, it has been noted that people become less motivated to continue the Vivitrol and will consequently go back to using opiates.

Vivitrol is also used for alcohol dependence. Here Vivitrol is not uniformly effective and at best, one can only expect a very modest improvement in drinking behavior. This is not to say that I do not support the use of Vivitrol, however it should be used with ongoing support after people are released from jail. As such, I believe that this is a public health issue, not a jail issue. Therefore, before one gets involved with allowing Vivitrol in jail, you need to be reassured by the public health department that there is a program of ongoing aftercare. This aftercare continues to monitor these people and give them the behavior modification and support that they are going to need.

If you decide to allow Vivitrol to be used in your facility it is important that you use the public health protocol and you let at least 7-10 days lapse between discontinuation of the opiates and initiation of Vivitrol therapy. Vivitrol can precipitate sudden opiate withdrawal that can be very severe. If this was inadvertently given to a pregnant female who was still coming off of her opiates, you could precipitate a sudden withdrawal and possible spontaneous abortion of the child. While Vivitrol is a fairly safe drug, it is not without some degree of risk.

If you decide to initiate a Vivitrol program in your facility, I strongly recommend that you contact Deb Ash, Vice President of Compliance, at our corporate office to assist you in ensuring that you have the proper protocols and all of the support systems in place to initiate this. Because this is a public health issue and not a jail issue, you should not be expected to incur any cost for this medication. If you have any questions concerning the use of naltrexone (Vivitrol) in your facility, feel free to call Deb Ash at our office at (309) 692-8100 or call me directly on my cell phone at (309) 648-3056.