Vivitrol
Monthly injectable naltrexone — for opioid and alcohol use disorder after completed detox
Overview
Vivitrol (extended-release naltrexone injection) is a non-opioid, non-controlled medication for opioid and alcohol use disorder. Unlike buprenorphine, Vivitrol works by blocking opioid receptors entirely (full antagonist) — it does not produce any opioid effect itself. For patients who have completed detox and prefer a non-opioid approach, or who have alcohol use disorder, Vivitrol is a compelling option.
How It Works
Naltrexone is a full opioid antagonist — it binds to opioid receptors with high affinity and blocks them completely. Any opioids taken while Vivitrol is on board produce minimal or no effect, removing the reinforcing properties of opioid use. For alcohol use disorder, naltrexone reduces the reward and craving associated with alcohol consumption, reducing use frequency and amount.
Induction & Dosing
- Must be completely opioid-free for at least 7–10 days before first injection (to avoid precipitated withdrawal)
- Oral naltrexone challenge test can confirm opioid-free status before injection
- Administered as a 380mg intramuscular gluteal injection once monthly
- Requires confirmed opioid-free status at each monthly injection
Available Formulations
- Vivitrol 380mg IM injection (gluteal) — once monthly
- Oral naltrexone 50mg tablets (daily, less reliable adherence)
- Only Vivitrol provides sustained, consistent blood levels without daily dosing
MAT With Direct Physician Access
Recovery requires support between appointments. With Dr. Agresti's concierge model, you have his direct cell number — text him about cravings, side effects, or concerns without waiting weeks for the next scheduled appointment. This level of access is especially critical in early MAT when induction and dose adjustment require close monitoring.
Schedule a MAT ConsultationCommon Questions
Who is Vivitrol best for?
Vivitrol is ideal for: patients who prefer a completely non-opioid approach, patients with alcohol use disorder, patients who have successfully completed detox and have strong motivation and supports, and patients who want the freedom of monthly (rather than daily) treatment.
What if I take opioids while on Vivitrol?
Vivitrol blocks the effects of opioids. Taking opioids while on Vivitrol will produce little to no effect. However, after Vivitrol wears off, opioid tolerance is significantly lower — using opioids after Vivitrol wears off carries high overdose risk. Patients must understand this risk.
Does Vivitrol work for alcohol use disorder?
Yes — Vivitrol has FDA approval for both opioid use disorder and alcohol use disorder. It significantly reduces alcohol cravings and the rewarding effects of drinking, reducing consumption and relapse rates. It is one of the most effective medications available for alcohol use disorder.