Vivitrol, increasingly being tried by courts, prisons and jails across the United States to fight repeat heroin abuse, offers a long-lasting treatment option advocates say addresses the day-to-day struggle of recovering addicts. Here are five things to know about the drug:
HOW DOES IT WORK?
Vivitrol uses monthly, extended-release injections of the opiate blocker naltrexone, which prevents heroin users from getting high. It's an alternative to daily trips to methadone clinics, isn't potentially addictive like other drug treatments and provides a buffer for recovering addicts.
"It's very difficult to ask an opiate addict to adhere to a daily regimen of taking a pill that will reduce their addiction," says Richard Pops, CEO of drugmaker Alkermes PLC. "The secret of Vivitrol, or its major contribution, is its once-a-month dosing format that actually provides a safety net for the patient."
HOW LONG HAS IT BEEN AROUND?
A daily pill form of naltrexone had been tried before without significant success. The longer-lasting version was approved for alcoholism treatment in 2006 by the Food and Drug Administration, and Vivitrol was approved in 2010 for heroin, morphine and other opoid drugs. At the time, the FDA called it "a significant advancement in addiction treatment."
WHY THE INTEREST FOR NEWLY RELEASED INMATES?
Heroin overdose deaths have soared across the country amid a surge in use of more widely available, cheaper heroin than before. Federal statistics show a 45 percent rise in heroin overdose deaths from 2006 to 2010. Studies have shown that fatal overdose rates are high among inmates newly released from correctional and treatment facilities because their bodies have been detoxified and can't handle the same level of opiate as before. A Vivitrol injection gives them a month to resist their old urges and begin post-release counseling.
WHAT ABOUT SIDE EFFECTS AND RISKS?
Patients must be opioid-free when they start taking Vivitrol or could experience severe withdrawal symptoms. They should be aware that resuming drug use after stopping Vivitrol treatment could make them more susceptible to overdose.
There also can be severe reactions at the injection site, including tissue damage. Other potential side effects include liver damage, depressed mood and suicidal thoughts.
WHY ISNT IT IN WIDE USE?
Although an estimated 2.5 million Americans are addicted to prescription painkillers or heroin, less than half are receiving a medical treatment and only a fraction are on Vivitrol. It's relatively new, skeptics question its long-term efficiency and price — injections can cost $1,000 or more — and some doctors and officials are reluctant to use drugs to treat drug problems.
Pops, the drugmaker's CEO, says the cost of heroin-linked crime, prison inmates and fatal overdoses is much steeper. "It's extremely gratifying and at the same time extremely frustrating. It takes time."
Sources: FDA, Alkermes, AP research