The Won­der Drug?

Vancouver Magazine - - The Fixer -

For suf­fer­ers of opi­oid ad­dic­tion, the jour­ney isn’t over when they get out of detox. Willpower alone is a frag­ile de­fence against mon­strous crav­ings— more than 80 per­cent of users will re­lapse, stud­ies sug­gest. But a new drug may im­prove those odds.

Viv­it­rol is a slowre­lease ver­sion of the “opi­oid an­tag­o­nist” nal­trex­one. It works by jam­ming the opi­oid plea­sure re­cep­tors in the brain, so users are de­prived of their ex­pected high. But the drug has another ben­e­fit: it sharply di­min­ishes crav­ings for opi­oids in the first place. While nal­trex­one ther­apy has been around for a while, it has draw­backs. Re­cov­er­ing ad­dicts in Canada have to visit a phar­macy ev­ery day to get an oral dose of the drug, which even­tu­ally proves too much has­sle for many re­hab­bing users.

Viv­it­rol’s slow re­lease is the gamechanger. A sin­gle in­jec­tion lasts up to a month,

mak­ing it much eas­ier for users to com­ply with the treat­ment. A Rus­sian test us­ing the treat­ment in 2010 had such dra­matic re­sults, the FDA ap­proved it for use in the United States on the ba­sis of that study alone.

Cana­dian au­thor­i­ties have been more cau­tious. Last fall, St. Paul’s Hospi­tal be­gan the first clin­i­cal trial of Viv­it­rol in Canada, ad­min­is­ter­ing in­jec­tions to 25 test sub­jects, all for­mer heroin ad­dicts. A pos­i­tive out­come will likely nudge Canada closer to ap­prov­ing it for use here.

But while Viv­it­rol may be a promis­ing step in ad­dic­tion treat­ment, re­cent Amer­i­can tri­als sug­gest it should be con­sid­ered a man­age­ment strat­egy rather than a “cure.”

When Viv­it­rol was used to treat al­co­hol depen­dency, most users were able to cut down their drink­ing. But very few—un­der 10 per­cent—quit drink­ing out­right.

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