For Alcohol Dependence Why VIVITROL® naltrexone for extended-release injectable suspension

Naltrexone is usually not prescribed past the first year of alcohol treatment, as it is not intended for long-term use. Prior to taking naltrexone, you should discuss possible side effects with your medical provider. Also, be sure to inform them of any medications – prescription and over-the-counter – that you are currently taking. Because some medications can cause adverse reactions when combined with naltrexone, it is imperative to discuss this with your medical provider. An individual must have a trial of oral naltrexone before starting long-acting injectable naltrexone to ensure they do not have an allergic reaction or intolerable side effects.

During medical detox, nurses and doctors are able to keep track of your vital signs and adjust your treatment as necessary. Concerns about experiencing this unpleasant reaction discourage those taking disulfiram from drinking alcohol. More severe reactions including chest pain, difficulty breathing, heart failure, and death are also possible.

What is the most important information I should know about VIVITROL?

A recent positron emission tomography study demonstrated that persons with alcoholism have increased opiate receptors in the nucleus accumbens of the brain and that the number of receptors correlates with craving. Like naltrexone, acamprosate seems to work best for people who are able to stop drinking before starting treatment. When you have alcohol use disorder, just thinking about alcohol triggers a pleasurable response in the brain. Other things, such as having low self-esteem or being impulsive, may raise the risk of alcohol use disorder. A support group or care program may be helpful for you and your loved ones.

Medication compliance can be a problem, however, and disulfiram is most effective when provided with supervised administration by a significant other or health care provider (Krampe and Ehrenreich 2010). The spectrum of unhealthy alcohol use can be addressed in a variety of health care settings, including primary care, specialty practice, and alcohol treatment programs. Medication use in these nonspecialized settings and in a spectrum of patients including nondependent individuals is a recent phenomenon. Recent studies of continuing-care interventions suggest that interventions of a year or longer and treatments that are less burdensome can promote sustained engagement and positive effects (McKay 2006). As discussed above, the use of medications by primary care providers may be a viable approach to providing low-intensity longer-term treatment. In a survey of medially hospitalized patients with alcohol dependence (Stewart and Connors 2007), 66 percent agreed that they would like to receive a medication that would help prevent drinking, and 32 percent were interested in primary care treatment.

Can Medicine Help With Alcohol Use Disorder?

Antidepressants are not effective in decreasing alcohol use in persons without coexisting mental health disorders.36 Antidepressants can be helpful in some instances, however, because patients with AUD often have coexisting mental health disorders. A trial randomized 170 patients with alcohol dependence and depression to 14 weeks of cognitive behavior therapy plus sertraline (Zoloft; 200 mg per day), naltrexone (100 mg per day), both medications, or double placebo. Those taking a combination of sertraline and naltrexone had higher abstinence rates and a longer delay before relapse to heavy drinking compared with those taking placebo or either agent alone. The implementation and widespread use of medications to treat alcohol problems faces a unique set of barriers in primary care. Although primary care providers are proficient at prescribing a wide variety of medications, they generally are unfamiliar with medications for treating alcohol problems other than those used to treat alcohol withdrawal.

You don’t feel the “high” pleasure sensation that makes you want to drink. Disulfiram (brand name Antabuse) is another medicine that is sometimes used to treat alcoholism. Naltrexone does not make you feel sick if you drink alcohol while taking it. With less than one percent of those seeking help for alcohol dependence receiving a prescription, medication is underutilized.

Naltrexone for Alcoholism

Unfortunately, some insurance providers will not cover the costs of the device, so it’s important to check with your provider before opting for this type of naltrexone. Tablets are sold under the brand names ReVia and Depade, and are generally taken once per day. While tablets are the most commonly prescribed type of this medication, it can be difficult to remember to take the pill at the same time every day.

When their bodies don’t have alcohol, they experience withdrawal symptoms. Herbal supplements like Ashwagandha, kudzu, milk thistle, and St. John’s wort may reduce alcohol sober house withdrawal symptoms and prevent cravings. If you are unable to quit drinking with support groups and therapy alone, you may benefit from intensive outpatient treatment.