Vivitrol is the intramuscular injection form of Naltrexone, which has been shown to be an effective treatment for patients suffering from alcohol and opioid addictions. It is one of several FDA approved medications for the treatment of alcohol and opioid use disorders, and was initially approved in October 2010. The medication works in the brain, by decreasing the desire to drink or use opioids (such as heroine). This medication is usually injected into the buttocks by a clinician, and lasts for 30 days. Benefits of this medication are that the patient does not need to take the oral Naltrexone every day, and it is therefore helpful with compliance, and the levels of the medication in the body are also maintained at a steady level, instead of the cyclical highs and lows of blood levels of the medication during a 24 hour period, which usually occur with taking the oral Naltrexone pill. Additionally, for patients that take the oral Naltrexone, if they forget to take their doses as prescribed, they are at higher risk of relapse of using alcohol and opioids. It is important that patients who are given this form of treatment are not on any opioid medications (usually used for pain control or opioid addictions), as this medication will block the effects of any opioids. Additionally, patients should carry a card indicating that they are using this medication, as emergency providers will need to know that opioid medications (such as Percocet, or Morphine) are unlikely to be effective, and therefore non-opioid medications (like Toradol, Tylenol, Motrin) will need to be used.
This is a recent US News article that discusses the increasing adoption of telepsychiatry across the nation, especially in states such as California, Texas, South Carolina, and Colorado. With telepsychiatry, patients are able to receive psychiatric care from the comfort of their own homes, without driving to the doctor's office, waiting in the waiting room, and offering additional privacy:
Many people who suffer from anxiety disorders frequently resort to alcohol as a way to treat their anxiety. It is often seen as a way to cope with various social stressors in someone's life. This short term solution seems to help reduce their anxiety, but unfortunately, chronic alcohol use then becomes a problem of its own. Often, tolerance, where higher amounts of alcohol are needed to produce the same effect, leads to chronic health problems such as cirrhosis, anemia, nutritional deficits, etc. It is imperative in these cases to treat the anxiety and the alcoholism sufficiently so that patients do not put their lives and other people's lives in danger (such as through impaired driving). Additionally, alcohol is a depressant and can lead to depression, and even worsened anxiety. Many patients who use alcohol at night, use it to reduce their anxiety, feeling it helps them to fall asleep. Continued daily and heavy alcohol use increase the risk of alcohol addiction. Although it may seem like an effective sedative for sleep, it unfortunately leads to poor deep sleep (stage 4 and REM (rapid eye movement) sleep), leaving the body less rested than expected. Drinking alcohol can be especially dangerous when combined with other medications, especially sedatives.
Dr. Chung is a Fullerton psychiatrist, and will post blog articles about all things related to mental health.