ReVia and Vivitrol are different forms of the medication naltrexone commonly used to treat both opioid use disorder and alcoholism. Naltrexone is an opioid antagonist that blocks other opioids from interacting with the brain’s receptors.
As a result, individuals on naltrexone can use opioids and alcohol without feeling their pleasurable effects. This can be an effective way to deter individuals in recovery from using again. For this reason, naltrexone is one of the most popular medication-assisted recovery treatments for opioid and alcohol dependence and addiction.
ReVia is a pill, and Vivitrol is an extended-release injection. ReVia can provide users with more control over their recovery and less invasive and easier to administer since it can be administered at home. Conversely, Vivitrol must be injected by a health provider, and a single one shot lasts about four weeks.
Naltrexone Side Effects
Like many medications, naltrexone is associated with side effects, such as the following:
- Headache and dizziness
- Nausea and vomiting
- Loss of appetite
- Joint aches and pain
- Constipation or diarrhea
- Sexual problems (impotence)
Liver damage, respiratory infections, and arthritis may also be side effects associated with long-term naltrexone use. Because this medication is not habit-forming, it can be used for months or years if needed, but this may increase the likelihood of more severe side effects.
Cravings and Withdrawal
One of the most common misconceptions about naltrexone is that it can help alleviate withdrawal symptoms caused by opioids or alcohol. While naltrexone blocks certain chemicals from attaching to opioid receptors, it does not mitigate the severity of withdrawal symptoms.
To relieve opioid withdrawal symptoms, an individual would need a partial opioid agonist similar to buprenorphine, such as Suboxone, although this would not help with alcohol withdrawal. For this, a barbiturate or benzodiazepine is often administered in clinical settings. Furthermore, naltrexone does not eliminate cravings for alcohol or opioids.
Use of Naltrexone with Alcohol or Narcotics
As noted, the naltrexone in Vivitrol and ReVia blocks the effects of specific substances. Attempting to get drunk or using them will be much less likely to result in desirable sensations.
It’s important to note that naltrexone can only be effective to a certain extent. As such, some persons, particularly those who have been given Vivitrol, may try to overcome this block by consuming more of their drug(s) of choice than usual. The problem is significant—the amounts needed to overcome the effects of naltrexone are often perilously high, and many have overdosed while on naltrexone for this reason.
Finally, instead of initially attempting to abstain entirely, some people use naltrexone using the Sinclair Method. This approach to alcohol dependence treatment uses a pharmacological extinction technique, which relies on an opioid blocker to change habit-forming behaviors into habit-extinguishing behaviors. The end effect is intended to help individuals return to a “normal” level of alcohol cravings, such as those they may have had before addiction.
Although seeming quite logical in theory, this approach isn’t always successful in achieving abstinence. Over time, sometimes just a matter of weeks, a person’s brain can override naltrexone’s effects, inciting a return of some pleasurable feelings during episodes of drinking. This, in effect, can neutralize naltrexone’s effectiveness entirely.
Naltrexone Effectiveness vs. True Opioid Replacement Therapy
Studies have shown that the two most effective methods of opioid replacement therapy and recovery are buprenorphine and methadone. Compared to naltrexone, these medications tend to have a much higher success rate. One of the reasons for this difference might be patient resistance to continuing treatment. However, some health experts contend that the real issue is that the drug isn’t being prescribed or used correctly.
Still, naltrexone certainly has its benefits. Because naltrexone has nearly zero potential for abuse, it is far more accessible than other drugs. For instance, opioid withdrawal medications such as Suboxone can only be prescribed by specially licensed health providers because it contains buprenorphine, a drug that can be abused.
Also, the law restricts these providers to a specific number of individuals to whom they can dispense these medications. This limit was enacted in an attempt to counteract the overprescribing of medications with a high potential for abuse. Regarding methadone, only specific facilities operating under strict controls are permitted to treat persons with this drug.
Another benefit of naltrexone is that it is not an opioid in and of itself and is considered by many to be preferable to other treatment methods, mainly because it is not an actual opioid.
This fact is critical when you consider a larger debate that’s been ongoing in the world of recovery for some time. Some persons think that treating addiction with another potentially addictive drug is misguided at best and entirely irresponsible at worst.
In fact, despite the clinically-proven benefits of using medication-assisted treatment, some people contend that it is only exacerbating the problem. And while science doesn’t always agree, those who feel this is true sometimes fight to pass laws that make this type of treatment less accessible. One advantage of naltrexone, therefore, is that it can be helpful for those who are not able to be addressed with other means that could be more effective.
It’s also worth noting that naltrexone remains one of the very few treatments for alcoholism that has been shown to be effective. Alternative medications, such as Antabuse, are being used less and less in place of naltrexone’s proven ability to fight alcohol addiction without horrific side effects, such as vomiting.
A Word on Drug and Alcohol Tolerance
The use of ReVia can reduce an individual’s level of tolerance when taken over an extended period. In an ideal world where people didn’t experience relapse, this wouldn’t be as much of a concern. Unfortunately, about half of all individuals with a substance use disorder do relapse at some point.
If drug use is again reinstated at a lower tolerance, the risk of overdose is far greater. For persons who aren’t aware of this effect of naltrexone and choose to go back to using at the same intensity as before, it may end up being a fatal mistake.
Using Naltrexone as a Component of a Complete Recovery Program
Similar to some false beliefs about other medications, some individuals may be under the impression that the primary factor in successful recovery is simply continuing to use naltrexone. However, the truth is that there’s much more involved in this process, and if it were as simple as merely taking a pill every day or getting a shot, there would be a lot more people inactive, long-term recovery.
Battling withdrawal symptoms and the cravings that can occur is just the first step in a balanced and comprehensive treatment program, such as one offered by Just Believe Detox and Just Believe Recovery. The real work begins during therapy and counseling by getting to the root of addiction and the many factors that contribute to it.