The medication “Vivitrol” is gaining traction as a tool in the fight against drug addiction. It’s a once-a-month injection that was approved as a treatment for opioid and alcohol users in 2010. A psychiatric hospital in Hampstead now prescribes the medication, and patients seem to show signs of improvement.
Mya Casela of Manchester knows what it's like to be an addict. She's shot heroin for nearly 20 years.
“It’s ruined my life a million times, but still, the feeling that it will give you is almost worth it. . . it’s amazing how these things will make you feel.”
She says even seeing 16 people die of overdoses wasn't enough to stop her from using. Once, Casela became pregnant and didn't know it for five months.
“And I was doing everything. I mean the amount…it’s just disgusting. That is something that will make me cry. And I’ll carry that guilt for the rest of my life.”
The baby was healthy, but it didn't keep Casela away from heroin. She’s tried to quit, using detox programs and recovery drugs like Suboxone, but those didn't work. Then she heard about Vivitrol, which brought her to Hampstead Hospital.
That's where she met Doctor Kenneth Brown. He's Medical Director of the “Recovery Matters” Program at Hampstead Hospital. He has been prescribing Vivitrol, the brand name for the drug Naltrexone, since it was approved to treat addiction. He says he’s only seen positive effects with his patients.
“…repaired relationships with family, job improvement, feeling better about themselves…”
In Brown's opinion, Vivitrol works better than other recovery medications, such as Methadone. He says that’s because, “it’s an opioid antagonist. An antagonist is something that blocks a receptor."
So it blocks you from feeling the effect of drugs, which reduces the incentive to use them. Vivitrol shuts down the receptors in your brain that are triggered by drugs to release dopamine. Other recovery medications activate them, maintaining a little buzz. But Vivitrol is different.
“It’s not a narcotic. It’s not inducing pleasure.”
Nor is it addictive. Which seems like what you would want, coming off an addiction. But not all doctors agree that Vivitrol is the best solution.
"It’s not magic," says Chery Wilson, Nurse Manager of the Adult Detox Unit at Hampstead Hospital. She says Vivitrol is not a panacea. Vivitrol requires patients to go through a full detox, which is a painful first step. Suboxone and Methadone offer a more gradual and accessible transition out of addiction.
Additionally, Wilson says that getting one shot every month is not enough to cure addiction. If a patient isn't also enrolled in programs of therapy and rehabilitation, the injection can fall short. Wilson says sometimes people don’t show up for an appointment, “and we find out later they’ve died of an overdose, or a suicide.”
Cost has been another issue, partly because Medicaid doesn't pay for therapy programs or the initial detox.
On July first, that will change. Jay Gonzalez is CEO of New Hampshire Healthy Families Insurance, which administers the state's Medicaid program. He's worked with the state to extend insurance coverage to those additional programs. He says covering therapy is expensive, but it gives patients a better chance of staying healthy long-term.
"Our hope is that they’re going to be cured of their addiction and they will be in a place where they’re in recovery and with the right supports will continue to be successful."
Studies show that Vivitrol reduces opioid cravings by half, which greatly decreases a patient's chance of relapse. And when paired with counseling, the medication has shown decreased rates of recidivism in recovering addicts. Patients normally take Vivitrol for a year or longer.
As for Casela, she wants to stay on it as long as she can.
"I'm probably going to be a lifer on something like this."
And that's because it's working. She says Vivitrol has given her a huge boost towards recovery. She’s happy. She has energy. And she has a reason to live.
“I live for my son to be healthy and happy; I live for my husband, who loves me more than life itself; and I live for, I pray, that this will be the last time.”