How to Reverse Vivitrol

Is It Possible to Reverse Your Vivitrol?

It’s possible to reverse the effects of Vivitrol through the use of certain drugs. This kind of reversal typically only happens in hospital or emergency settings, usually in situations that require the effects of Vivitrol to be reversed to allow for easier pain management.[1]

Importantly, “reversing” your Vivitrol is different than simply stopping your medication. Since Vivitrol is an injectable medication given in a healthcare facility, stopping use means you don’t return for your next monthly injection of this form of medication-assisted treatment (MAT). 

While you should never just stop an addiction treatment without talking to a doctor about why you want to stop and which alternatives are available, stopping your Vivitrol treatments will cause its effects to slowly fade. Reversing the drug’s effects through the use of other drugs will have a more immediate effect. If you simply want to stop using Vivitrol, talk to your prescribing doctor about how to best do this.

Common pain management alternatives to the reversal of Vivitrol include the following:[2]

• Regional, targeted painkillers
• Non-opioid painkillers
• General anesthesia
• Conscious sedation

How to Reverse Vivitrol

In hospital or emergency settings, with the oversight of a doctor who believes the reversal is necessary, the effects of Vivitrol are typically reversed through the use of the medication remifentanil. As mentioned earlier, this is typically done only in situations where a patient needs pain management treatments that Vivitrol will interfere with.

There doesn’t appear to be data on how commonly this type of reversal is performed, but there are reports of doctors doing this. This type of reversal needs to be performed with care. It essentially involves overcoming the blockade effect of Vivitrol by administering an especially high dose of an opioid. Remifentanil is most commonly used because it has an ultra-short duration of action, which makes it less dangerous for overcoming a Vivitrol blockade effect compared to the alternative opioids that might be used for that purpose.

Is It Dangerous to Try & Reverse Vivitrol?

Vivitrol is generally a medication prescribed to treat either opioid use disorder (OUD) or alcohol use disorder (AUD). In either case, this means a person is taking Vivitrol in an attempt to avoid relapse. You should never try to undo the effects of Vivitrol without a clear plan guided by a medical professional, especially because the medications used to do this, like remifentanil, are themselves prescription drugs.

Reversing the Vivitrol blockade effect should typically only be done in situations where pain management needs to take priority, and opioids, which Vivitrol can interfere with, are the only reasonable pain management solution. This is one reason it should only be done in emergency or hospital settings. The type of moderately severe to severe pain that would likely warrant such a reversal would already be a serious enough situation that a doctor should already be involved, such as pain caused by a surgery, car accident, or serious medical ailment such as cancer.