Vivitrol treatment for OUD and AUD.
Vivitrol (extended-release naltrexone) is a monthly intramuscular injection used for opioid use disorder and alcohol use disorder. Unlike agonists, Vivitrol blocks the opioid receptors entirely — no abuse potential and no overdose risk from the medication itself.
Most major commercial insurance plans cover Vivitrol.
Commercial insurance plans typically cover Vivitrol for opioid use disorder and alcohol use disorder. Pharmacy benefit administration varies by plan — call admissions and we'll verify your specific plan.
The three phases of Vivitrol treatment.
1. Opioid-free window
Vivitrol requires patients to be opioid-free for 7–14 days before the first injection. Receiving Vivitrol with opioids still in the system precipitates immediate, severe withdrawal. Medical detox supports a safe transition through this window.
2. First injection
Vivitrol is administered as a 380 mg intramuscular injection. The dose suppresses opioid effects and reduces craving for approximately 30 days. The first injection is administered in a clinical setting after a clinician confirms the opioid-free window.
3. Monthly maintenance
Subsequent injections are administered monthly, paired with ongoing therapy and clinical check-ins. Duration is individualized. Many patients remain on Vivitrol for a year or more; some continue indefinitely. The decision is clinical, not arbitrary.
Vivitrol vs. Suboxone vs. methadone.
| Suboxone | Methadone | Vivitrol | |
|---|---|---|---|
| Mechanism | Partial agonist | Full agonist | Antagonist |
| Setting | Office-based | OTP only | Office-based |
| Frequency | Daily oral | Daily on-site | Monthly injection |
| Pre-treatment opioid-free | ~12–24 hrs | None required | 7–14 days |
| Overdose risk profile | Low (ceiling effect) | Moderate | None |
| Abuse potential | Low | Moderate | None |
Common questions about Vivitrol.
Does insurance cover Vivitrol?
Hickory Grove works with commercial insurance for Vivitrol for opioid use disorder and alcohol use disorder. Pharmacy benefit administration varies by plan; admissions verifies your specific plan as part of that first conversation.
Why does Vivitrol require an opioid-free window?
Vivitrol is an opioid antagonist — it blocks opioid receptors. Receiving Vivitrol with opioids still in the system displaces the opioid from its receptors and triggers immediate, severe withdrawal. The 7–14 day window allows the body to clear opioids before the receptors are blocked.
Can Vivitrol be used for alcohol use disorder?
Yes. Vivitrol is FDA-approved for both opioid use disorder and alcohol use disorder. The same mechanism — opioid receptor blockade — reduces both opioid cravings and alcohol's rewarding effects.
What happens if I use opioids while on Vivitrol?
Opioids will not produce their usual effects because the receptors are blocked. Attempting to override the blockade with high-dose opioids is dangerous and carries serious overdose risk, particularly as the Vivitrol dose wears off and tolerance is gone.
Talk to admissions about Vivitrol.
Admissions answers 24/7. We work with commercial insurance and verify your specific coverage on the call.