NEW LIFE ADDS VIVITROL TREATMENT MEDICATION BLOCKS OPIOID ACTION
N ew Life Addiction Counseling Services recently expanded its medication-assisted treatment services by adding Vivitrol, a relatively new injectable medicine used to treat alcohol dependence and prevent relapse to opioid dependence.e U.S. Food and Drug Administration approved Vivitrol for the treatment of alcohol abuse in 2006. Vivitrol is an extended-release formulation of naltrexone. While naltrexone hydrochloride is for both daily and once-a-month dosages, Vivitrol is the once-a-month formulation of the medication. Vivitrol is an opioid antagonist, which means it blocks other opioids from acting on the receptors in the brain and can also help ease drug cravings. By blocking the e ects of other opioids, it removes the pleasurable e ect, which can help with preventing relapse. Although it is not fully understood why an opioid antagonist works in treating alcoholism, it is believed that Vivitrol blocks the pleasurable e ects of alcohol by blocking the release of endorphins triggered by alcohol. Vivitrol binds to the opioid receptors in the brain, produces no opioid e ects, and does not allow other opioids to enter. Because Vivitrol is an antagonist, it will cause withdrawal in patients who still have any opiates in their system when they take the medication. For this reason, patients need to have gone through detoxication prior to starting the medicine and have – ideally – not taken any opiates for 7 to 14 days before their rst Vivitrol injection.
Vivitrol needs to be accompanied by counseling. Research has shown that opioid-dependent patients who received both counseling and Vivitrol had signicantly more days of complete abstinence, stayed in treatment longer, reported less craving, and were less likely to relapse. One of the main problems with the daily dosages of naltrexone has been medication compliance; patients have to remember and be willing to take the pills each day. However, with the once-a-month Vivitrol shot, medication compliance is less of a problem, research indicates. ”Clients like the advantage of not having to take a daily pill.” – Sofia Arnold, New Life nurse practitioner MONTHLY SCHEDULES At New Life, most patients who receive the Vivitrol injection take it on a monthly basis, although a few are on three-week schedules, says nurse practitioner Soa Arnold, who manages the Vivitrol program. Arnold, who recently joined the sta at New Life, is a Kansas native who trained in family medicine, but says she has always been drawn to the addiction medicine eld. She received her nurse practitioner degree from Fort Hays (Kansas) State University and her RN degree from Newman State University in Wichita. Patients who receive Vivitrol at New Life are closely monitored by their prescribing physicians.e drug's manufacturer, Alkermes Inc., has advised that recipients' liver enzyme levels need to be monitored, Arnold
notes. Patients typically have blood drawn and lab tests conducted in order to make sure all enzymes are within normal parameters, Arnold says. Vital signs such as blood pressure and heart rate are checked at each visit. Some Vivitrol users experience side e ects, such as headaches, depressed mood, nausea, fatigue and dizziness. e most common side e ect seems to be headaches, but they usually lessen with each subsequent injection, according to Arnold. Arnold says some of the clients she has seen have received other therapies and treatments for their addiction, but are still struggling. “Some of these clients tell me they like the advantage of not having to take a daily pill,” Arnold says. “ey really like the fact that once the Vivitrol is in their system, it stays there for four weeks; there is a comfort in that.ey usually say that, 'ere's no point in drinking or trying to use' because they know it's not going to have the desired e ect.”
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