Vivitrol Use in Los Angeles County: An Evaluation of Medication-Assisted Treatment

Introduction: Vivitrol, when used in conjunction with psychosocial treatment, can significantly decrease the urge to use opiates and alcohol; thereby reducing the chances of relapse. Vivitrol is the long-acting (30-day) injectable form of Naltrexone which blocks the mu-opioid receptors in the brain. These receptors are responsible for the “high” or “buzz” experienced when alcohol is consumed. If receptors are blocked, the “high” is no longer experienced and cravings for alcohol are reduced. Prior implementations of medication assisted treatment (MAT) also indicated that counselor attitudes play a major role in medication use by treatment participants. Methods: In 2010, Los Angeles County began a pilot test Vivitrol within three treatment programs. To address counselor attitudes toward MAT, educational sessions were also provided to counselors to increase their knowledge about Vivitrol and buy-in. Counselors were surveyed before and 3 months post-educational groups. With regard to substance abuse treatment participants, after a physical exam to determine eligibility, they were given Vivitrol. Data were collected on participants' urge to drink and medication side effects weekly for the first four weeks (with baseline at the time of the initial shot) and monthly thereafter for as long as the participant was in treatment. Results: Counselor attitudes, although mixed in the beginning of the pilot, improved after training and education. Participants reported significant drops in their cravings and reduced primary drug use. Conclusion: Vivitrol is a feasible MAT within community based settings for individuals with chronic alcohol/opiate use problems.