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Using Vivitrol to Promote Recovery

Tarzana Treatment Centers in Los Angeles is participating in Recovery Month 2009, in part, with articles about recovery during the month of September.  Most individuals suffering from alcoholism and drug addiction begin their recovery with alcohol and drug treatment.  So it is our pleasure to help bring awareness to the general public about the benefits of recovery to individuals, their families, and everyone with whom they interact.

Early recovery brings many challenges for those suffering from alcohol dependence.  Relapse, the biggest challenge, has the power to reverse and possibly erase all progress during this time.  Since alcohol cravings are a major relapse trigger, it is a good thing that advances are being made in medication assisted treatment.

For those who do not suffer from alcoholism, these cravings may be difficult to understand.  An easy way to get the picture is to think of a favorite food.  Did your mouth begin to water? The difference, of course, is that alcohol is deadly to the alcoholic.  But even after many years of abstinence, the sight of James Bond with a martini can bring similar reactions to an alcoholic in recovery.

Although these cravings subside in frequency over time, they can be downright overwhelming in early recovery.  Motivation for recovery can help carry individuals past cravings as they occur.  But most of the time, a relapse is the result.  When questioned as to why they drank, they answer with an indication that they were only trying to satisfy an intense craving.

Researchers understand craving for alcohol in different ways depending on their disciplinary backgrounds.  Psychologists may use concepts of reinforcement, social learning or cognitive processing to explain why we crave alcohol.

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Many theoretical models attempt to explain the phenomena associated with craving. Although no single model accounts for all aspects of craving, each has elements that may eventually contribute to an overall, comprehensive model. Key characteristics of selected models are described below.

  • The reinforcement model is based on alcohol's ability to produce an elevated mood or to help relieve an unpleasant mental state such as stress or anger. An unconscious learning process called reinforcement leads to repetition of the behavior (i.e., drinking) that produces the positive experience. Eventually, objects, environments, or emotions consistently associated with alcohol consumption can produce a similar response as powerfully as can alcohol itself. Such stimuli (i.e., cues) may include the sight of a bar, liquor store, or beverage advertisement; the company of friends who drink; or exposure to alcohol itself. An abstinent alcoholic exposed to appropriate cues will experience a conscious urge, or craving, for alcohol.
  • According to the social learning model, cue-elicited craving during or after treatment can trigger conscious coping strategies aimed at maintaining abstinence. The success of coping depends on the drinker's confidence in his or her ability to resist the urge to drink. This model acknowledges craving as only one of several factors necessary to induce relapse.
  • The cognitive processing model postulates that alcohol use becomes a habit which requires little conscious effort or attention, just as driving down a familiar road can become automatic. In this model, craving represents the effort involved in mobilizing conscious problem-solving skills needed to block the automatic drinking behavior. Such a situation may occur when a drinker finds that his favorite bar is unexpectedly closed. Similarly, following treatment, an alcoholic who is motivated to remain abstinent might experience craving while consciously attempting to avoid cue-induced relapse.

-- Source: http://pubs.niaaa.nih.gov/publications/aa54.htm  --

Neuroscience explains craving based on brain chemistry, specifically on the regulation of the neurotransmitters endogenous opioids and dopamine.  So medications have been developed with a purpose to reduce alcohol cravings for those in recovery.  Simply put, when the spigot of chemicals is turned down or off, cravings are less likely to manifest.

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Medications to interrupt the process of reinforcement are being investigated. The key neurotransmitters involved in reinforcement include the endogenous opioids and dopamine. The endogenous opioids are a group of brain chemicals similar in action to morphine. They appear to amplify the pleasurable effects of rewarding activities and have been shown to help maintain drinking behavior. Naltrexone helps prevent relapse and reduce craving by blocking certain opioid receptors, presumably reducing the pleasurable effect of alcohol.

-- Source: http://pubs.niaaa.nih.gov/publications/aa33.htm --


Tarzana Treatment Centers Los Angeles has been using Vivitrol with patients for over a year beginning in September 2008.  We’ve provided the medication to over 120 patients in the past year.  Vivitrol is Naltrexone in the form of a monthly injection which blocks the euphoria associated with alcohol use.   Patients report that cravings for alcohol and other drugs are reduced.

Tarzana’s experience with Vivitrol began with participation in a pilot project sponsored by Los Angeles County Alcohol and Drug Program Administration and Alkermes, the manufacturer of Vivitrol.  Use of Vivitrol at Tarzana has been greatly expanded through the Alkermes Touchpoints program.   Touchpoints provides the initial Vivitrol injection to any patient free of charge.   

Follow-up interviews with Vivitrol patients in treatment indicate positive results overall.  Patients who have relapsed on several prior occasions, with little recovery time, reported greater motivation and hope after being injected with Vivitrol.  So Vivitrol does indeed appear to aid those in alcohol treatment toward long term recovery.

At Tarzana Treatment Centers we use the Urge to Drink Scale to assess patients for medication assisted treatment with Vivitrol.  During the admission process they are informed about the use of Vivitrol and given literature explaining details about the medication.  We are also finding that our Vivitrol patients are privately recommending it to other patients who are approved for use.

While Vivitrol is not a miracle drug, it has proven to be effective for many patients as a helpful tool on the road to long term recovery.  This medication assisted treatment may not stop relapse from occurring, but it offers a solution to alcohol cravings which tend to lead to relapse in early recovery.  This is not just about reducing an annoyance.  With reduced alcohol cravings patients can focus more on other issues that may trigger a relapse, thus giving them an even greater chance at long term recovery.

If you would like more information about medication assisted treatment with Vivitrol at Tarzana Treatment Centers, please call us now at 888-777-8565 or email at vivitrol@tarzanatc.org.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.




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