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What is Vivitrol?

By Manjari Bansal, Kyle Kirkland
Vivitrol is given as monthly injections to help you quit opioids or alcohol. Find out more about how to use it successfully.

If you're a good candidate for naltrexone or you've already had some success using this drug but it's difficult to remember to take a pill daily, your doctor may recommend Vivitrol. Vivitrol, a monthly intramuscular naltrexone injection, can be used for either opioid or alcohol dependence. It works by blocking the effect of substance on your brain. Here’s everything you need to know about this important medication that could be a vital part of your long-term recovery.   

The Vivitrol Shot: Extended-Release Naltrexone

“Vivitrol is the brand name of the injectable form of the medication naltrexone,” Zach Ludwig, LPC-S, NCC, VP of Clinical Services & Accreditation at Bradford Health Services, tells WebMD Connect to Care. “It is a medication administered by a trained provider about once every four weeks and has extended-release of the medication that is used in the treatment of alcohol and opioid use disorders.”

The medication naltrexone is available in both pill and injectable forms, notes the Substance Abuse and Mental Health Services Administration (SAMHSA). The pill form of Naltrexone (ReVia) is used for treating alcohol use disorder, while the extended-release intramuscular injectable form (Vivitrol) can be used for both alcohol as well as opioid use disorder.  

“The reason someone would prefer [Vivitrol] over the daily tablet form of naltrexone is to ensure compliance,” Daniel Hochman, MD, a Psychiatrist and Founder of SelfRecovery.org, tells WebMD Connect to Care. “A lot of people either forget or lose motivation to take medication, and Vivitrol helps prevent that. It’s not addictive at all since it’s not an opiate itself, and there’s also no withdrawal.”

“The pill format for naltrexone does not demonstrate reasonable efficacy in treating OUD [Opiod use disorder]. However, the injectable form which lasts for a month, can be used to treat OUD and is a reasonable substitute for partial agonists such as buprenorphine/naloxone sublingual,” Monty Ghosh, MD, Addiction Specialist at the University of Alberta Hospital in Edmonton, tells WebMD Connect to Care.

Vivitrol treats both disorders differently but with similar results.

“For opioids, it completely blocks the opioid receptors in the brain, making it impossible to get high from heroin or other opioids for a month,” Sarah Church, PhD, Founder and Executive Director of Wholeview Wellness Centers, tells WebMD Connect to Care. “For alcohol, it blocks the euphoric rush of endorphins that are released when someone drinks, but it doesn’t keep them from becoming intoxicated.” 

“However, because it reduces the pleasure in drinking, people tend to drink less often and when they do drink, they tend to drink fewer drinks,” Church says.

“For patients who have found oral naltrexone to be helpful in reducing their drinking, but who have repeatedly struggled with taking the medication regularly, a monthly shot can be used to increase compliance with the medication,” Church says. “Some people find it more convenient to receive an injection once monthly rather than having to remember to take a pill every day.”

One benefit of naltrexone is that it blocks opioid receptors (preventing the “euphoria” of the substance from occurring), which eliminates the risk of misuse and makes it a safe way to treat substance use disorder.

Using Vivitrol for Opioid Addiction

Vivitrol has been approved by FDA (Food and Drug Administration) for the treatment of both opioid use disorder and alcohol use disorder, according to the SAMHSA. Any healthcare provider holding the license to prescribe medicines can prescribe or administer Vivitrol. However, UMass Medical School notes that providers may defer to colleagues with better training in opioid use disorder to do the prescribing.

“The role of Vivitrol in opioid addiction is to help make sure someone is compliant with treatment,” Hochman says. “Vivitrol will block the opiate receptor so you can’t abuse opiates anymore. It’s generally used after someone hasn’t been consistent with taking daily naltrexone tablets, or there’s good reason to expect they won’t stay motivated enough.” 

For individuals using Vivitrol as a medication-assisted treatment for opioids, it is important to maintain at least 7 to 14 days of abstinence from all opioids prior to Vivitrol inoculation,” Aaron Sternlicht, LMHC, CASAC, a therapist and co-founder of Family Addiction Specialist in New York, tells WebMD Connect to Care. “Otherwise, an individual may experience sudden and intense opioid withdrawal symptoms such as nausea, vomiting, diarrhea, sweating, and other severe symptoms that may require medical attention.”


Also, “Vivitrol is used in treatment to assist in preventing relapse because it has anti-craving characteristics,” Ludwig says. “Vivitrol also works as an aid if someone does have recurrent use of opioids since the euphoric properties of the opioid are blocked by Vivitrol. Many patients report that Vivitrol provides a ‘safety net’ of sorts that helps their overall recovery goals since they know that if they take an opioid they will not experience the euphoric effects of the drug, as long as Vivitrol is still present in their system.”  

Using Vivitrol for Alcohol Addiction

“Even though Vivitrol targets the opioid receptor, it’s actually used for alcohol addiction too,” Hochman says. “The reason is because the medication helps with both cravings and reduces the pleasure from drinking.”

According to the SAMHSA, a patient should not be physically dependent on alcohol or other drugs when they begin their Vivitrol treatment. Therefore, in order to prevent serious side effects, like nausea and vomiting, doctors start Vivitrol only after the alcohol detox has been completed. 

“Vivitrol injections are given once a month to persons with alcohol use disorder,” Mark Jaffe, MD, Psychiatrist at Westwind Recovery Los Angeles, tells WebMD Connect to Care. “This has been shown to reduce the amount one consumes during a relapse and to shorten the duration of the relapse. If one begins drinking after receiving a Vivitrol injection, there are no harmful side effects. The effect is that the person drinking alcohol will not experience as much of a buzz or euphoria from the alcohol and will be more likely to just stop drinking. It has been shown to help people stay sober.”

“Vivitrol works most effectively when combined with other treatment approaches, such as counseling, family therapy, relapse prevention work, and engagement with mutual self-help groups,” Ludwig adds.

Can You Drink Alcohol on a Vivitrol Shot?

“There are no harmful effects from drinking alcohol-related to being on Vivitrol injections, but speak with your doctor,” Jaffe says. 

“While it’s highly recommended in most treatment protocols to be sober and avoid drinking with Vivitrol, it won’t cause a withdrawal or severe interaction like with opiates,” Hochman says. “That’s because the medication doesn’t block or remove alcohol, it just blocks the craving and reward pathway. There are many doctors who prescribe naltrexone or Vivitrol for active drinkers to help them reduce cravings and blunt the reward from drinking. It can be a great way to slowly wean off of alcohol with less struggle.”

“Unlike other medications used for treating alcohol use disorder, someone who drinks alcohol while on Vivitrol will not become ill,” Ludwig says.


“In fact, the negative experiences are no worse than the inherent risks of the alcohol itself. For someone who continues to drink alcohol while on the medication, they may find that their overall euphoria associated with the alcohol use is diminished because of the neurotransmitter-blocking qualities of the medication. This alteration to the way the brain responds to alcohol can reduce some of the reinforcement of drinking which can reduce the compulsions to continue to drink at all,” says Ludwig.

Your Vivitrol Timeline

“The timeline for utilization of a medication in the treatment of alcohol and opioid use disorder is based on conversations between the patient and the provider,” Ludwig says. 

“Ultimately, the patient is the decision-maker about medication choices and for how long they wish to be taking the medication. The prescriber’s role is to educate the patient about the pros and potential cons of the medication options available and how they can specifically assist the individual patient with their recovery goals.”

Ludwig tells WebMD Connect to Care, that factors that may influence the duration of treatment duration may include: 

  • Coexisting medical issues
  • Side effects experienced when taking the medication 
  • Consistency in going for follow-up appointments for Vivitrol injections

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