ReVia (naltrexone) is a medication that is commonly used to treat both opioid use disorder and alcoholism. The key ingredient in ReVia is naltrexone, an opioid antagonist that blocks other opioids from interacting with the brain’s receptors.
As a result, individuals on ReVia can use opioids and alcohol without feeling their effects. This action can be a very effective way to prevent people in recovery from being tempted to use again. For this reason, ReVia is one of the most popular medication-assisted recovery treatments for opioid dependence.
Facts about ReVia
Naltrexone comes in two forms – as a pill (ReVia) and as an extended-release injection (Vivitrol). ReVia provides users with more control over their recovery and is easier to administer since patients can use it at home. Conversely, Vivitrol must be administered by a physician, and one shot lasts about four weeks.
Importantly, naltrexone is not naloxone, although with similar sounding names both related to opioid addiction it’s easy to understand the confusion. While naltrexone chemically blocks the effects of most opioids (opioid antagonist), naloxone actually reverses the effects of opioids and is used by first responders as an overdose antidote. It is also used as a component in some other drugs (Suboxone) to prevent abuse.
Like most pharmaceuticals, ReVia is associated with a few side effects, including the following:
Liver damage, arthritis, and respiratory infections may also be side effects associated with long-term ReVia use. Because this drug is not habit-forming, it can be used for years if necessary, but this may increase the risk of more serious side effects.
Withdrawal and Cravings
One of the most common misconceptions about ReVia is that it can help mitigate withdrawal symptoms caused by alcohol or opioids. While ReVia blocks chemicals like opiates from binding to opioid receptors, it does not decrease the intensity of withdrawal symptoms.
To ease opioid withdrawal symptoms, a person would need a partial opioid agonist similar to Suboxone, although this would not help with alcohol withdrawal (for this, a benzodiazepine or barbiturate is often used in medical settings). Furthermore, ReVia does not reduce cravings for opioids or alcohol.
Use of ReVia with Narcotics or Alcohol
As noted, Vivitrol and ReVia block the effects of certain substances and attempting to get high or drunk while using them will be unlikely to produce many sought-after sensations.
Importantly, however, ReVia can only be effective to a certain extent. As such, some patients (particularly those who have been given Vivitrol) may try to overcome this block by consuming more of a drug than usual. The problem here is considerable – the amounts needed to circumvent effects of naltrexone are often dangerously high, and many have overdosed on ReVia for this reason.
Finally, rather than attempting to abstain initially, some people take ReVia using the Sinclair Method. The Sinclair Method is an approach to alcohol addiction treatment that uses a technique referred to as pharmacological extinction, or the use of an opiate blocker to transform habit-forming behaviors into habit-extinguishing behaviors. The effect is intended to be a return to a person’s “normal” level of alcohol cravings that existed before addiction.
Unfortunately for some, while quite logical in theory, this approach doesn’t always work. Over time, perhaps just a matter of weeks, a person’s brain can override the effects of naltrexone, inciting a return of pleasant feelings during bouts of drinking. This, in effect, neutralizes naltrexone entirely.
Effectiveness of ReVia vs. True Opioid Replacement Therapy
Research has shown that the two most effective methods of opioid replacement therapy and recovery are buprenorphine and methadone. Compared to naltrexone, these therapies tend to have a much higher success rate.
Perhaps some of the reason for this difference is patient resistance to continuing treatment. Some physicians contend, however, that it simply isn’t being prescribed appropriately.
But still, naltrexone certainly has its benefits. Because naltrexone does not have the potential for abuse, it is far more accessible than other drugs. For example, opioid withdrawal drugs such as Suboxone can only be prescribed by specially licensed health professionals because it contains buprenorphine, a drug which can be misused.
Also, the law restricts these providers to a set number of patients to whom they can dispense these drugs. This limit was put into place in an attempt to counteract the overprescribing of drugs with a high potential for abuse. Regarding methadone, only certain facilities operating under strict controls are allowed to treat patients with this drug.
Another benefit of ReVia is that it is not considered to be an opioid in and of itself, and is considered by some to be preferable to other treatment methods simply because it is not a true opioid. This fact is vital when you consider the larger debate that’s been happening in the world of recovery for some time. Some people think the concept of treating addiction with another potentially addictive substance is misguided at best, and downright irresponsible at worst.
In fact, despite the clinically-proven benefits of using medication-assisted treatment, people contend that it is only worsening the problem. And while science doesn’t really agree, those who feel this is true occasionally fight to pass laws that make this form of treatment less accessible. One advantage of ReVia, therefore, is that it can be beneficial for those who are not able to be treated with other means that could be more effective.
It’s also worthwhile to mention that naltrexone remains one of the very few treatments for alcoholism that is proven to be effective. Alternatives such as Antabuse are used less and less in lieu of naltrexone’s clinically-proven ability to fight alcohol addiction without the horrific side effect of vomiting.
Drug and Alcohol Tolerance
The use of ReVia can reduce a person’s level of tolerance when taken over a prolonged period. In an ideal world where people didn’t encounter relapse, this wouldn’t be as much of a concern. But, unfortunately, about half of people with a substance use disorder do relapse at some point.
If drug use is again continued at a lower tolerance, the risk of overdose is far higher. For those who aren’t aware of this effect of ReVia and choose to go back to using at the same level as before, it may end up being a lethal mistake.
Using ReVia as a Component of a Complete Recovery Program
Similar to some erroneous beliefs about other medications, some people may be under the impression that the only factor in successful recovery is simply continuing to use ReVia. The truth, however, is that there’s a lot more involved in this process, and if it were as simple as just taking a pill every day, there would be a lot more people in active recovery.
Battling the symptoms of withdrawal and the cravings that result is just the first step in a balanced and comprehensive recovery program. The real work begins during psychotherapy and counseling and getting to the root of addiction and factors that contribute to it.
If you are addicted to drugs or alcohol, please contact us as soon as possible to discuss treatment options and find out how we can help you restore sanity to your life and experience the long-lasting wellness and sobriety you deserve!