What Happens if You Drink Alcohol While on Vivitrol?

What Is Vivitrol?

Vivitrol is an injectable form of naltrexone that allows patients to take the medication just one time per month.[1]

A prescription drug, Vivitrol is generally used for the purpose of helping people in recovery from opioid use disorder or alcohol use disorder to avoid relapse. It binds to opioid receptors in the brain and helps to lower cravings for the substance of choice, which can empower people in recovery to stay focused on other aspects of treatment that are needed for sustained abstinence.[2]

Vivitrol helps to prevent overdose if the person takes opioids while the medication is in the system. It also prevents the person from feeling the full euphoric effects of opioids or alcohol. 

How Long Does Vivitrol Work?

Vivitrol stays in the system for up to 30 days. It may continue to have an effect on the person for weeks after the injection due to its long half-life.[3] 

The medication is designed to be a part of an overall treatment plan and not the sole means of support during recovery. Take the time to consider the pros and cons of Vivitrol before starting the medication and fully understand how it impacts the body during recovery before starting on a monthly regimen. Your treatment team will help you determine if this is the right form of medication-assisted treatment (MAT) for you.

Why Is It Not Recommended to Drink on Vivitrol?

There are a few different drugs used during the treatment of alcohol abuse and addiction. While Vivitrol is one of them, it does not have the same effects as some of the more aggressive medications like Antabuse (disulfiram).[4]  Antabuse triggers severe vomiting and other physical effects when alcohol is ingested. 

For Vivitrol, there are different issues that result when the medication is combined with alcohol. These are some of them:[5]

Reduced Efficacy of Vivitrol

Alcohol can make it hard for Vivitrol to bind with opioid receptors and block the effects of opioids. If you are taking the drug for the purpose of treating opioid addiction, it can put you at risk of relapse and overdose on opioids.[6]

Risk of Harm Caused by Alcohol

Though Vivitrol diminishes the euphoric effects of alcohol, it does not necessarily reduce alcohol’s other effects. While the drinker may not feel drunk or buzzed, they may still have difficulty thinking clearly, handling simple motor tasks, and avoiding risk-taking behaviors. They will also still experience the physical toll that alcohol takes on the body, such as high blood pressure, alcohol poisoning, and increased risk of injuries.[7]

Negative Impact on Recovery

Drinking alcohol while undergoing treatment for addiction—whether the substance of choice is alcohol or opioids—is a huge red flag that the combination of treatments and therapies is not working as intended. 

If opioids are the drug of choice, alcohol use can diminish the efficacy of Vivitrol. This increases cravings for opioids and reduces the protections against overdose that Vivitrol provides. 

If alcohol is the drug of choice, continuing to drink whether or not it provides the “buzz” will continue to damage organs that are likely already in distress due to past addictive alcohol use. For example, the liver, pancreas, and cardiovascular system will continue to be harmed by excessive alcohol use.[8]

What Could Happen When You Drink on Vivitrol?

When someone drinks alcohol while taking Vivitrol, they open themselves up to experiencing a spectrum of physical and mental health symptoms that range from uncomfortable to life-threatening. In most cases, it is not Vivitrol itself that causes these symptoms but the combination of alcohol and Vivitrol. 

Underlying medical conditions, mental health disorders, and personal issues like alcohol tolerance, the amount of alcohol consumed, and overall health can factor into exactly what the person will experience if they drink alcohol while taking Vivitrol. 

Physical Symptoms

It is not uncommon for people who combine alcohol with Vivitrol to experience any or all of the following symptoms in varying degrees of severity:[9]

• Nausea and vomiting
• Headache
• Dizziness or lightheadedness
• Fatigue or lethargy
• Flushed or red skin, especially on the face or neck
• Profuse sweating 

Mental Symptoms 

Alcohol is a depressant. Even without the combination of Vivitrol in the system, alcohol can take a toll on mental health, especially for those who are already diagnosed with a mental health disorder—something that is very common among those who are living with AUD.[10]

Some of the mental health symptoms experienced by those who drink while on Vivitrol include the following: 

• Impaired judgment and risky behavior
• Extreme emotions, especially sadness, anger, and irritability
• Difficulty concentrating and memory issues
• Confusion and difficulty processing information
• Anxiety, high stress, and agitation

How Long Will These Symptoms Last?

In most cases, the effects will last as long as it takes for the body to metabolize alcohol out of the system. Vivitrol remains in the body and active for 30 days, but alcohol has a half-life of about four or five hours, depending on the metabolism of the individual.[11] 

In other words, only about .015% of alcohol is processed out of the body per hour, but that may go slower if the person meets any of these criteria:[12]

• Has ingested a large amount of alcohol
• Has a slow metabolism
• Is taking other medication that interferes with the metabolic process
• Has taken other illicit substances (like opioids or benzodiazepines)
• Suffers from liver damage or dysfunction 

If the reaction is serious, emergency medical help should be sought immediately. Additionally, the person should reach out to their addiction treatment support professionals to address the situation as a relapse and determine how to get back on track in recovery.