Drinking on Vivitrol: Risks & Side Effects

There are several FDA-approved medications for addiction treatment. One such medication is Vivitrol, which may be prescribed and used for either alcohol use disorder or opioid use disorder treatment.¹

This page will cover what Vivitrol is, what happens if you drink on Vivitrol, Vivitrol side effects, and how to find treatment for alcohol use disorder.

What Is Vivitrol?

Vivitrol is a brand name, extended-release form of the opioid antagonist medication naltrexone. The extended-release form allows it to be administered once every 4 weeks, in contrast to the daily dosing required with the oral tablet form.¹

Naltrexone is what’s known as an opioid antagonist. When used, it competitively binds to opioid receptors throughout the brain. This receptor blockade results in a decrease in receptor activation by either exogenous (e.g., heroin, prescription painkillers) or endogenous opioids (e.g., natural endorphins).

Although the precise mechanism is not fully understood, naltrexone is subsequently associated with decreased alcohol consumption in people being treated for alcohol use disorder.¹

Naltrexone is also indicated in the treatment of opioid use disorders (e.g., heroin abuse, the abuse of prescription narcotic pain medications, etc.), though the NIAAA guide only details its role in helping individuals with alcohol use issues decrease their intake of alcohol.

Drinking Alcohol While on Vivitrol

Some of the utility of Vivitrol and other naltrexone products is in reducing cravings for alcohol. As mentioned, though the precise mechanism of action may not be entirely clear, its diligent use can result in a reduction in the amount of alcohol one drinks.

Although there are no immediate pharmacologic contraindications listed for drinking alcohol on Vivitrol, some issues may arise as a result of Vivitrol’s side effects if you drink.¹ For instance, some side effects may be increased in people who have developed certain serious physical issues as a result of chronic, excessive drinking (see below).

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) released a guide for clinicians that outlines the pharmacologic options for treating patients with alcohol use disorders. This guide includes some important details to consider regarding the use of alcohol and Vivitrol together:²

• Naltrexone products do not reduce the intoxicating effects of alcohol, such as physical issues with slowed reflexes and diminished coordination, and the characteristic effects on mental function.
• Using naltrexone does not result in an individual being able to drink more alcohol than normal; naltrexone does not increase one’s tolerance for alcohol.
• Naltrexone may help reduce cravings or urges to continue drinking alcohol once one has started drinking.
• The effects of naltrexone appear to be successful in reducing overall intake of alcohol.
• Though naltrexone may be useful in reducing cravings and the amount of alcohol that one drinks, it should be used in conjunction with a formal alcohol use disorder treatment program to maximize its therapeutic utility for those in recovery from an alcohol use disorder.

Most sources, like the FDA, suggest that an individual should be abstinent from alcohol for at least a week to 10 days before they take naltrexone products like Vivitrol in order for it to be most effective in reducing cravings for alcohol and reducing the amount of alcohol one consumes.⁴

What Are the Side Effects of Vivitrol?

Vivitrol and other drugs containing naltrexone have relatively few side effects, and the drug is considered to be safe to use in most individuals; however, every medication or drug has a side effect profile.

Naltrexone use may result in certain side effects:^1,5

• Nausea, diarrhea, and stomach cramps are the most common side effects.
• Headache, muscle cramps, or muscle stiffness may occur in some people.
• Some individuals may have issues with insomnia or hypersomnia (sleeping too much).
• Some individuals may experience jitteriness, anxiety, or irritability.
• People who are actively using opiate drugs or women who are pregnant should not use products that contain naltrexone.
• Naltrexone is contraindicated for use in people with hepatitis or liver failure, and people with either of these conditions (potentially in association with chronic alcohol use) may be at increased risk for serious liver complications if they use Vivitrol.

Vivitrol Alternatives

When managing recovery from alcohol use disorder, there are few medications that are safer than naltrexone (Vivitrol), except, possibly, acamprosate (Campral).⁶

The differences between Campral and Vivitrol include:

• Campral must be taken 3 times per day while Vivitrol is a once-a-month shot.
• Campral minimizes the imbalance of neurotransmitters, which improves mood but may not stop cravings.

Benefits of Campral compared to Vivitrol include:

• The person in recovery must be sober for 7 days before they can take Vivitrol while Campral only requires 5 days of sobriety.
• Campral may cause fewer side effects.

Ultimately, finding the best medication to reduce cravings and improve recovery outcomes after alcohol misuse involves a conversation between the individual and their doctor. However, Vivitrol is known as a very safe medication for most people.

Is Vivitrol Addictive?

No, Vivitrol is not addictive. It is an opioid antagonist, so it binds to opioid receptors in the brain without creating any rewarding euphoria or other potentially-desirable psychoactive effects. Unlike opioid agonist medications, the drug is not a controlled substance, though it does require a prescription from a physician.¹

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