Thought I'd chime in on my experience. I'm an opioid addict (oxy 2 years, IV heroin/pills 2 years) and an alcoholic so I thought I found my miracle drug. While this could be a miracle drug, it requires dedication to recovery and sobriety and I am not dedicated to that yet. I received my first vivitrol injection on 12-18-18 and I'm currently on day 24. My decision to get the shot was purely impulsive. I had fully detoxed from heroin and alcohol and abstained for two months white knuckling prior to the injection. Worried about my cravings, I called my doc and scheduled an appt a week in advance. During that week I was hyped about getting it and felt that it was a wise and responsible decision. The day of my appt I started regretting it and a couple hours after the injection I basically mentally relapsed because I made the decision to try and use/drink while on the shot. Here's a chronicle of my experience up to day 24.
60 days leading up to the shot I used nothing but kratom - a lot of kratom. Over an ounce a day to help deal with my dope cravings (it barely sufficed). I used kratom daily leading up to the injection. I knew kratom has some sort of withdrawal but I was under the impression that it was comparable to a cold. I was craving heroin heavily and to a lesser extent alcohol during these 60 days.
Day of injection: My heroin cravings were through the roof and I amazingly did not use the day of. Got to my doctors office and started regretting this decision. She mixed up the shot, which looked like a milky suspension and stuck it in my rear. The needle didn't hurt but my rear was quite sore immediately after. I got the shot in the morning and went to work after. On the drive over I started feeling irritable. 30 minutes later I'm at my desk and my crash course in kratom withdrawal began. It was much worse than I expected but not nearly as bad as full blown dope sick. All the classic dope sick symptoms - cold sweats, aches, restless legs, depression but less intense. It was still quite uncomfortable. Cravings 10 out of 10.
Days 2-7: The worst symptoms of the kratom withdrawal lasted 7 days. I didn't sleep or eat much. The days felt 3 times longer and I was extremely depressed. Rather than taking advantage of opportunity to stay clean, I started drinking on day 5. It took all the fun out of being drunk and left me disoriented and sick. No alcohol pleasure whatsoever. Vivitrol supposedly helps with opioid cravings but that skyrocketed after geting the shot. Its probably all mental though because I decided I wanted to use on day one and the countdown to 30 days felt like an eternity.
Days 7-14: I've been craving heroin so badly and was restless, irritable and discontent just like the Big Book describes. I decided to test the opioid-blocking properties on day 10 with some kratom extract. All I got were the 'wobbles' and a headache. That day I also drank and still had the same pleasureless experience. Fast forward to day 14 and I get a text from my hydromorphone plug and couldn't resist. I got 10 hydromorphone 8mg pills. I IV'd 8mg (with a wheel filter - never shoot pills without proper filtration!) and got nothing but wasted money. No rush, no pins, no euphoria. However, the IV ritual was very satisfying. My appetite and sleep are still poor.
Days 15-24: Since day 14 I've been drinking daily and the pleasurable effects have slowly returned. I committed to save the hydromorph until at least day 28 but being the junkie that I am, decided to experiment. On day 18, I shot 16mg and experienced mild sedation but not even a satisfying sort of sedation. About 10-15% of the high. No where near nodding out. Feeling frustrated, I went crazy the evening of day 18 and shot ketamine, drank, sniffed coke and smoked weed until the early morning. The ketamine experience was slightly less satisfying but still fun (maybe just circumstantial). Vivitrol had no effect on coke or weed but I'm not much into those substances. I just craved that opioid blanket of warmth and pleasure very badly. On day 20 I shot another 16mg of hydromorph and got some slightly satisfying sedation and warmth but no rush or pins (25% of the high). I debated going higher on my dose but it sounded it bit unsafe considering respiratory depression can still happen even though there is no high. Since day 20 drinking has been relatively satisfying but I really haven't craved a drink all that much. Vivitrol has only helped with my alcohol cravings. I'd say my alcohol cravings are half what they usually are. I really only drank to gauge the efficacy of vivitrol, not to get drunk. However, vivitrol has done nothing for my opioid cravings from day 1 until as of now, day 24. If anything my cravings greatly increased but like I said earlier, I am not all that dedicated to quitting opioids at the moment. Today, day 24, I shot another 16mg and had a satisfying rush and nod. Probably around 60-70%.
In summary, vivitrol works great on blocking opioids and reducing alcohol cravings for me. It absolutely did not help with opioid cravings. I'm taking sertraline 100mg for major depressive disorder, which has worked great for me. But while on vivitrol my depression has been worse than ever. I used coke on day 18 regardless of my distaste for that shit just to mask my feelings. As others have mentioned, vivitrol can work great for those who are working a program of recovery. In my case, it has been miserable because I made an impulsive decision to get the shot even though I knew I'm not ready to quit. Also, kratom withdrawal sucks and anybody who plans on getting the shot should be fully detoxed from opioids. Usually 7-14 days per the manufacturer. Folks on bupe or methadone should probably wait even longer, like 3 weeks. Today is day 24 and I'll update my experiences with vivitrol.