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Speaker 1: (00:02)
[inaudible].

Speaker 2: (00:08)
Hey Dr. Ken Starr here, I want to answer the question for you. When can I get Vivitrol? This is important and I’m talking about for opiate dependence, not alcohol use disorder, which is a different topic altogether. You can only get Vivitrol when you are fully detoxed off of opiates. Okay. A lot of patients who come to the clinic are a little bit confused about the difference between Suboxone and Vivitrol and so forth. If you are on an opiate, whether it’s a pain pill or heroin or fentanyl or methadone or Suboxone or buprenorphine, if you have that in your system, you take Vivitrol or naltrexone that binds that receptor so it’s a much stronger magnet than any of those other substances. Much stronger magnet, much less activity precipitated withdrawal. No bueno, nosuper sick, right? If you’re on Vivitrol or you’re on naltrexone, you’re stable on it and then you use opiates, then it’s a blunted response.

Speaker 2: (01:01)
Now obviously it depends on the dose, but in general those receptors are occupied and there’s a cover over them. So if you use opiates, then it’s, it’s blunted and you have less effect. Um, sometimes even no effect. So the manufacturer’s recommendations, seven to 10 days, lots of drug and alcohol doctors will do it shorter than that, but the patients have to know that there are risks for precipitated withdrawal. If you’re considering this, you might want to do a test dose of a small amount of naltrexone first, but it’s enough that when you stop using opiates on your own, you have a natural slow kind of off-gassing of opiates at your system. That’s why withdrawal is days and days and days. If you were to take Vivitrol too early or naltrexone too early, it just super sick right away precipitated withdrawal. That’s what you want to avoid.

Speaker 2: (01:50)
All right, so the question is when can I get Vivitrol? Wait, as long as you can wait, as long as you can maybe have your provider give you a test dose of Narcan or naltrexone, which is a shorter-acting version of the same, and then you can do it. Now if you get a Vivitrol shot, remember that it doesn’t even work for several hours and it doesn’t get to a high level, a peak level for seven days or longer. So keep that in mind. But it’s great medicine for early recovery. It’s a great insurance policy if it’s something you’re thinking about and you’re motivated. Do I love it when my patients do a Vivitrol shot every month, then I don’t need to worry about them. I said, 28-day life insurance policy. They like it, their family likes it. Um, it’s great, but just don’t get it too early, lots of patients that we’ve seen over the years have had precipitated withdrawal. That’s it for now. Okay. Be careful with naltrexone. Be careful with Vivitrol. Make sure your detox before you take it. Thanks.

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