Vivitrol-how do you do it?

Buprenorphine Post
tstinson
Posts: 16

Postby tstinson » Fri Sep 25, 2015 8:48 am

The "electric massager" may be a vortex mixer. I use one called a Vorndo. It costs under $200. from a vendor on the internet. It is much easier and works better than shaking Vivitrol to suspend it.

drpasser
Posts: 1404

Postby drpasser » Fri Sep 25, 2015 8:48 am

This seems quite erudite of some jails to give Vivitrol:

http://www.drugfree.org/join-together/jails-prisons-provide-vivitrol-departing-inmates-reduce-opioid-use/?utm_source=Stay+Informed+-+latest+tips%2C+resources+and+news&utm_campaign=8bfc2e42a2-JT_Daily_News_Some_Jails_and_Prisons_Provide&utm_medium=email&utm_term=0_34168a2307-8bfc2e42a2-223226245

:-)

m_kaylor
Posts: 22

Postby m_kaylor » Fri Sep 25, 2015 8:48 am

I have zero on it for opiate. Like MChaplin I offer it but no takers. 6-7 on it for alcohol and they really like it. I've had good results using naltrexone in 2 patients with sex addiction. They all say decreases cravings and when they do drink/engage in problem behavior it isn't as rewarding and reinforcing

cruser
Posts: 10

Postby cruser » Fri Sep 25, 2015 8:48 am

Electric massager? I am giving my first shot this week so I am intrigued.

MChaplin
Posts: 183

Postby MChaplin » Fri Sep 25, 2015 8:48 am

i currently have exactly zero patients on vivitrol- i offer it to everyone- almost everyone feels it will not help them with cravings and won't try it or says they can't stay clean long enough to get on it- or says if they can stay clean for a week they don't need medication (!!) the few patients i have successfully given one injection to have only come back for one more at most....if anyone has a better track record can you please weigh in? on paper, it is a great treatment....

MChaplin
Posts: 183

Postby MChaplin » Fri Sep 25, 2015 8:48 am

I use the same protocol though I also get a quick read urine screen and give the first 1/4 in the office- I think that enhances the efficacy- because it is similar to what I do for bup.....makes me more confident that they truly are opioid free.

DrBallester
Posts: 84

Postby DrBallester » Fri Sep 25, 2015 8:48 am

I explain to them that they have to be free of opioids for at least 1 week, they can try oral naltrexone (50 mg) a fourth of a tablet. If they don't have any withdrawal reaction after 2 hours, take another fourth, take the rest of the tablet if they don't have any problems. As soon as they can tolerate 50 mg daily, we try to get the Vivitrol kit from the specialty pharmacy.

In my small practice I've had 4 patients that had not undergone in-patient detox and injection before coming to my office.

Just recently an alcohol dependent patient was refused the injection because he could tolerate the oral tablet.

I had a patient with opioid use disorder, his wife is a Physician, and she forced him while providing supportive care to take the tablet, he received the injection for over a year and stopped, It was not clear if they could not afford it or he decided to stop. He always stressed to me that it took away the urges and opioid cravings.

BTW, I use an electric "massager" to mix the powder in the vial, after had several episodes of clogged needles, manually shaking the vial.I also agitate the syringe with the massager/vibrator before the injection.

There is a Physician in Pittsburgh that claims the withdrawal is short lived, (a couple of hours)


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