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Friday, April 27th, 2007

Vivitrol continues to perform

Posted by Roberta Jewell
Categories: Medications and research

Vivitrol

John started drinking as a teenager, stealing booze from his parents’ liquor cabinet. Once he became an adult, his problem only worsened, ultimately wreaking havoc on his personal and professional lives.  

“I was staying out late, coming home drunk,” said John, 62, a married Bergen County, N.J., businessman who requested that his last name not be used.

Today, John says, he hasn’t touched a drink in almost six months. And he points to his backside while making that declaration of sobriety.

Once a month, John receives a shot in his buttocks that seems to turn off his craving. Vivitrol is the first-ever injectable medication for alcohol dependence.

Approved by the federal Food and Drug Administration in April 2006, Vivitrol is an injectable version of an oral medication — naltrexone — which has been used for more than a decade.

Doctors think Vivitrol works by blocking neurotransmitters in the brain associated with alcohol dependence.

Some patients who have tried to drink while taking the injections no longer report a “buzz.”

It’s not right for everyone

“One of my patients said it was like drinking lemonade,” said Sharad Wagle, chief of psychiatry at Holy Name Hospital in Teaneck, N.J.

Raye Litten, associate director of the Division of Treatment and Recovery Research at the National Institutes of Health, said that though Vivitrol won’t work for everyone, “it gives clinicians a greater menu of medications to choose from.”

Some addiction specialists are giving it even higher marks.

Because the shot is given in the privacy of a doctor’s office and the effects in the body last the entire month at an accepted therapeutic range, the social stigma associated with being an alcoholic is virtually removed, they say.

“It legitimizes the disease, and you don’t have to feel demoralized,” said Hugo Franco, a staff psychiatrist at the Carrier Clinic, an addiction treatment facility in Belle Mead, N.J.

Even when people do reach out for help, they can still be resistant to treatment, said Jeffrey Berman, president of the New Jersey Society of Addiction Medicine. “Patients might fill the prescription, but then it winds up sitting in the medicine cabinet.”

Of 24 patients he has treated with Vivitrol, 12 have remained off alcohol.

Six others relapsed and are no longer in treatment.

Six others “binged” but immediately got back into treatment, he said.

“It’s not a silver bullet,” Berman said.

Tempting environments

Since John started getting his shots, he reports, he has been in plenty of situations where he might have been tempted to drink. He even admits he has a “burning desire” to try it just to see what happens, but he doesn’t yet feel he’s strong enough. 

“I have been in bars and at parties where I talk it (Vivitrol) up while I’m drinking club soda and lime,” he said.

One day, John hopes to stop the injections.

“I’m almost over the hump,” he said.

John’s doctor, family physician and addiction specialist Aleksandr Martirosov, who practices in Fair Lawn, N.J., says most of his patients are giving him positive feedback: “They say it’s working.”

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