Heroin belongs to the opioid family which is derived from the opium poppy. Heroin is an illegal substance, extremely addictive and is considered a Schedule I drug according to the U.S. Drug Enforcement Agency. This intravenous drug has been increasing among users, leading to more deaths secondary to overdoses.
Heroin use in the United States has increased by a staggering 286 percent between 2002 and 2013, according to the Centers for Disease Control and Prevention. In the same report, the CDC states that heroin use has increased among demographics that hadn’t historically used this opioid — particularly women, those in high-income brackets and the privately insured. Also between 2002 and 2013, heroine-related overdose deaths have almost quadrupled. In 2013, more than 8,200 individuals died from heroin overdose.
Painful withdrawal from opioids
Withdrawing from heroin or any other type of opioid is extremely painful. Side effects include severe gastrointestinal upset such as nausea, abdominal cramps and diarrhea, restlessness, severe aches and pains and irritability. Opioid withdrawal is known as the most painful withdrawal. Due to the severe withdrawal side effects, it is very difficult to quit using this class of drugs and, therefore, pharmacological therapies continue to be released to help prevent relapse.
Vivitrol is the injectable form of naltrexone that can be administered on a monthly basis. Naltrexone is a well-known opioid antagonist used for the treatment of opioid addiction. It was first introduced in clinical trials for opioid addiction treatment in 1973. Specifically, naltrexone is used to prevent relapse after withdrawal from opioids. It is extremely important that the body is completely free of opioids when naltrexone is administered, because severe withdrawal effects will occur as this medication will act to eliminate all opioids from the body.
Better compliance, fewer side effects
In 2005 the Food and Drug Administration approved Vivitrol for the treatment of alcohol dependence and in 2010 the FDA approved this same drug for the treatment of opioid dependence. This once-monthly injectable form of naltrexone is considered to be safer and more efficacious than the oral form. Most patients can agree that taking a pill every day is difficult to remember, so it is not surprising that the compliance rate is much higher when a long-acting drug form is administered.
This injectable form of naltrexone is a much lower overall dosage than the oral form, making it safer for the body and causing fewer potential side effects. Vivitrol has a total dosage of 380 milligrams over a four-week period compared to the oral form of daily naltrexone, which is 1,500 mg. The oral form of naltrexone is first metabolized or broken down by the liver, which is known as first pass metabolism. Because the injectable form of Vivitrol does not undergo first pass metabolism, it has less potential for liver toxicity compared to the oral form.
Cost and other requirements
Monthly Vivitrol injections are not cheap, costing between $800 and $1200 per month, and the total duration can be anywhere from three to 15 months depending on the rehabilitation facility and the patient.
Patients must be opioid free for a minimum of seven days and there can be no current signs of withdrawal before this injection can be administered.
Relief from opioid addiction
This injection has been administered in prison to those who are addicted to heroin and it has shown to help these prisoners live a relapse free life.
Just like any other illness, there are many different forms of treatment and each specific treatment works differently from one person to another. Vivitrol is just another avenue to get clean from opioid addiction.
The co-occurring conditions is a leading co-occurring conditions provider with locations across the United States that help treat people with addiction, mental health disorders and co-occurring conditions. For more information, please call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.