This week, on a very gray and slushy Monday in Massachusetts, I went with my husband to an appointment where he received a Vivitrol shot. Vivitrol is an injectable form of a medication called naltrexone. It lasts for 30 days.
Naltrexone (Vivitrol) is a newer medication available for treatment of opiate and alcohol addiction. It is not addictive and is a non-opioid medication, unlike methadone and suboxone. It works as an opioid antagonist by blocking opioids from acting on the receptors in the brain. It binds to the opioid receptors and blocks the effects of opioids, making it impossible to get high with naltrexone in your system, which can help with preventing relapse. It also reduces drug cravings. This opioid antagonist is also used for treating alcoholism. Although not completely understood, it is believed that naltrexone decreases the pleasurable effects of alcohol by blocking the release of endorphins caused by drinking.
Some other positives about naltrexone include that there’s no risk of abuse, addiction, or overdose, and so it has no street value. Some risks include: while it prevents one from getting high, overdose from opioids can still occur and there is a risk of liver toxicity, especially for opiate addicts that suffer from hepatitis C.
The first time we learned about naltrexone and Vivitrol was in San Diego. At the time my husband was in therapy for his addiction. He had refused rehab, saying he couldn’t take a leave from work and that he could beat the demon in therapy. I didn’t know s$@& and I was living in a half state of denial and half state of ignorance. So I accepted therapy as an alternative to rehab. Anyway, during his time in therapy he was diagnosed with bipolar. Turned out that was not the appropriate diagnosis and his manic and depressive behavior was a manifestation of speed balling. He had us all fooled; me, the psychologist, and the psychiatrist, all the while riding the destructive suboxone train. Saving the subs for a rainy day, keeping them as back up in case he ran out of H, and trading them on the street. Cycling through opiates, held deep deep in the grips of addiction. This doesn’t mean I’m saying suboxone is a bad alternative for someone else. I’m just saying it didn’t work for my husband.
I actually just found out he detoxed off of dope with suboxone on our 3,000 mile drive cross country from CA to MA, driving a 16 foot truck with all of our stuff, towing our car, and our 2 cats and chihuahua. Yeah we were a freaking traveling circus. Wow what a s#%@ show. I thought the first 2 days seemed a bit rough for him…denial is a powerful force.
So back to the Vivitrol shot. He received it at a local facility called HKD. Before rehab he had made about 5 appointments with them, but only made it to one. This was after his inpatient stay in a dual diagnosis unit for about a week over the summer. They released him with naltrexone pills, and a referral to HKD. He managed to get close enough to have the Vivitrol ordered and delivered. The medication had to be specially delivered from a pharmacy in Florida. It was delivered about 4 months ago. When he returned from rehab, we worried that they hadn’t held it for him. But they did. The young woman who administered the shot told us it had been sitting on the bottom of the fridge. She said, smiling, “I knew you would be back”. My eyes dampened with tears, her words like perfectly wrapped blessings, gifts of hope and nonjudgment. Here was someone else who believed in my husband. Someone who was there to help, even after the missed appointments and the no-shows.
Here’s what addicts and their families need to hear from professionals: “you didn’t make it 10 times, but that’s okay because you made it the 11th, I will be here when you get up, no matter what happened before that, I believe in you, I’m not giving up on you.”
On the car ride home after the shot, my husband told me that before rehab he had always had the intention to make it there, but just couldn’t stay clean long enough. It doesn’t matter now, he was meant to go away to rehab. “Everything happens for a reason”, my husband told me. Before he wasn’t ready; he needed a real treatment program, more clean days, time off the street, real clean time to work on himself, and an opportunity to start working the steps. He was meant to take that path to recovery.
Rehab has given him a real shot at recovery and sobriety. Vivitrol is also giving him a “shot” at staying sober while he re-enters the real world, works the steps, and continues with counseling and therapy. We call it his safety net. My husband states that since he’s been taking naltrexone, starting it in rehab, and now with the shot, his cravings are minimal. He describes them as thoughts that he can manage and control. Thoughts he can work through and that always end in the same conclusion: “getting high isn’t worth it, I want to be clean and sober.” Is it naltrexone? Yes. Is it meetings? Yes. Is it treatment? Yes.
I can’t begin to tell you how many times he lied about the Vivitrol shot. How many appointments “they canceled”, how many he “rescheduled “, how the medicine “wasn’t shipped yet,” how they were “waiting for drug test results”. The knot in my throat rises and bulges, cutting off my airway, as I revisit the devastation I felt every time he lied, the dead look in his eyes, me fearing for his life, not wondering if, but when, I would have to use the Narcan stashed in the drawer. This time, getting the shot was seamless: appointment, drug test, shot, schedule next appointment. It’s amazing how much easier these things are in sobriety.
On Monday my husband had 63 days sober. I watched him get the Vivitrol shot. After that he went to a meeting. I wrote and went to the gym. I feel like we finally have a shot at life together.
Some info about Naltrexone and Vivitrol: