I have been court ordered to take Vivitrol...please respond, I really need some advic

[Damitri the Greek]

Okay, so I have been court ordered to take vivitrol for a DWI that I got.

I have no history of opiate abuse, and the judge has ordered me to take vivitrol specifically for alcohol addiction.

However, I have really bad kidney stones and am prescribed hydrocodone on a regular basis.

What should I do?

I have no desire to do opiates other then when my kidney stones begin to aggravate me. When that occurs I'm in an extreme amount of pain for 24 to 48 hours.

Will the vivitrol lessen the affects of the hydrocodone?

I know the doctor can always trump the judge's decision to take a medication based on health reasons. I have high liver enzymes so I'm hoping that this will cause the doctor to not approve the vivitrol.

Are there any other medications the doctor could suggest I take that deal specifically with alcohol, and not opiates?

Any help/advice would be greatly appreciated.

 

[Lolie]

Naltrexone has a long history of being used in the treatment of alcohol dependence, especially as an implant or depot injection. It can increase your sensitivity to opiates when taken over a period of time so your doctor would need to adjust your doses of hydrocodone accordingly as you need it in the future. Disulfuram is a much nastier drug used to discourage drinking, but far more dangerous than naltrexone. There are other drugs used off-label but they often have high risk profiles.

While in theory it's desirable that your liver enzyme levels are stable before starting on naltrexone, in reality the risk is likely to be balanced against the risk of continued alcohol intake.

I presume that you'll be required to be alcohol free during the period of the order which may influence your doctor's decisions.

 

[BIGsherm7272]

Naltrexone has a long history of being used in the treatment of alcohol dependence, especially as an implant or depot injection. It can increase your sensitivity to opiates when taken over a period of time so your doctor would need to adjust your doses of hydrocodone accordingly as you need it in the future. Disulfuram is a much nastier drug used to discourage drinking, but far more dangerous than naltrexone. There are other drugs used off-label but they often have high risk profiles.

While in theory it's desirable that your liver enzyme levels are stable before starting on naltrexone, in reality the risk is likely to be balanced against the risk of continued alcohol intake.

I presume that you'll be required to be alcohol free during the period of the order which may influence your doctor's decisions.

umm Naltrexone blocks opiates, so he will get no relief from his hydrocodone. It might make you more sensitive to opiates because while on it you can't get high, thus lowering your tolerance.

 

[Damitri the Greek]

Anyone else have any input?

 

[JamtasticX]

I don't think it's right that a judge, who doesn't have a degree in medicine, is ordering you to take a medication.

Then again I don't know all the circumstances of the case, so it's hard to say. However, you're talking about other medications to deal with just alcohol, it sounds like you have a serious problem, esspecially with DUI's. In that situation the judge can force you to take a drug or send you to jail, and you don't have an argument....

Naltrexone will completely block the effects of hydrocodone. It's an opiate antagonist, with a high affinity. Unfortunately if the judge want's you to force to take this drug or go to jail, then you won't be able to take opiates any more

 

[psychomimetic]

umm Naltrexone blocks opiates, so he will get no relief from his hydrocodone. It might make you more sensitive to opiates because while on it you can't get high, thus lowering your tolerance.

I believe that naltrexone actually reduces opiate tolerance (not just because it prevents you from getting high). I've read studies in which ultra low dose naltrexone was administered along side an opiate and the result was that no tolerance developed to the opiate and there were few if any withdrawal symptoms when dosage was stopped.

 

[Damitri the Greek]

So bottom line: I will feel no affects from the hydrocodone while on the vivitrol...correct?

This is probably a stupid question, but bare with me...does that include oxycotin?

 

[mister right]

Especially, Oxycontin. I was in rehab for opiate addiction and when I got out, I used percocet for about 2 weeks. I went to a doctor to get on Suboxone and because, at that time, I had no opiates in my system he put me on Naltrexone instead. Well, I got really sick, so I must have had some still in my system (that he of couse, ignored) Believe me when I tell you that Naltrexone COMPLETELY blocks any effects of ANY opiate (heroin, percocet, vicodin, oxy, morphine......etc.) No doctor in their right mind would even prescribe the two together.

 

[JamtasticX]

So bottom line: I will feel no affects from the hydrocodone while on the vivitrol...correct?

This is probably a stupid question, but bare with me...does that include oxycotin?

correct, you won't be able to do any opiates unless you find one that is stronger than naltrexone.

Bupe is stronger than naloxone, however, naltrexone is significantly stronger than naloxone, so I can't think of any opiate that would work.

 

[Cane2theLeft]

Unfortunately I think that high liver enzymes demonstrate necessity FOR the naltrexone more so than causation to block implementation. If you have demonstrable medical necessity for the pain medication, that would be more justifiable to deny this legal measure (which I also agree is unconscionable to be imposed at all, let alone by someone devoid of a medical degree).

As has been stated, naltrexone will effectively block the opioids and while its theoretically possible to break through with potent enough opioids or sufficiently high doses, no doctor is going to prescribe 10x as much pain medication (or precisely whatever is required to break through).

There are a lot of pain treatment options out there and while they may not be AS effective as opioids, many come close. I have been experiencing chronic pain for nearly 5 years and I'm well versed in the options so PM me for more information on that specifically. My point in this is that even if this IS imposed on you, you won't just have to suffer with the kidney stone pain.

I believe that naltrexone actually reduces opiate tolerance (not just because it prevents you from getting high). I've read studies in which ultra low dose naltrexone was administered along side an opiate and the result was that no tolerance developed to the opiate and there were few if any withdrawal symptoms when dosage was stopped.

First off... big difference between ULD and standard naltrexone treatment (by a factor of 50 or 100 in dosages). Next, what you read was either incorrect or exaggerating the effects of ULD administered concomitantly with opioids; while its shown some promise in reducing tolerance acquisition, it doesn't outright stop the process.

When people develop tolerance to most drugs what happens is the brain creates more receptors so it takes larger amounts of the drug to achieve the same effect. When you take naltrexone, not only do you block exogenous opioids (such as hydrocodone or oxycontin as the OP mentioned) but endogenous ones as well (endorphins, enkephalins and dynorphins) so tolerance to any exogenous or endogenous opioids can drop below baseline with prolonged naltrexone treatment... not substantially so, but its possible.

 

[AfterGlow]

My guess is that the judge believes that you can't be trusted not to drink and drive and some means of ensuring your compliance is necessary. They could put you in jail, but I doubt you'd find that preferable over the Vivitrol. So ask yourself... what alternative means of verification can you provide to the judge besides taking Vivitrol?

You could offer to attend daily AA meetings and get an attendance sheet signed at each meeting. That will prove that you are taking action to deal with your alcohol problem. You could ask about wearing one of those alcohol detection anklets like Lindsay Lohan did. If the judge insists on a chemical solution, you could offer to take Antabuse (Disulfiram) instead. It interferes with alcohol metabolism and makes you violently sick if you drink.

 

[Cane2theLeft]

^good suggestions for alternatives.

OP, how many DWI's have you had?

 

[Damitri the Greek]

That's the thing...it's a really long, complicated story but I have not had a drink in over 4 years. I've had the SCRAM alcohol monitor on my ankle for over 2 years.

I'm on probation in two different counties. One judge is very pro-treatment and is genuinely trying to help me by taking away the "desire" to drink. Although I have no desire to drink, I know how to play the game...I'm not gonna disagree with a judge. He made that ruling in an effort to motivate the other judge to take the SCRAM monitor off my ankle. Unfortunately, the other judge could care less and at this point has not ordered the SCRAM monitor off. Therefore, I am forced to take the vivitrol AND wear the SCRAM device.

 

[AngelMom]

Can the scram bracelet detect other drugs beside alcohol?

I've been on Scram for 3 months now, without drinking has been so freaking boring. I ended up looking for some hydrocodone, and ran into friends with meth. I smoked it. Will Scram pic up on the ethanol in it and mistake it for alcohol? I was told that it only detects alcohol, but isn't ethanol alcohol? Please help!8(

 

[effie]

^ Hey, welcome to BL and BDD. I'm afraid we dont cover drug testing questions (which would cover this IMO) or legal queries, we're for harm reduction questions related to drug use

Also, if you do have a question that fits our guidelines (see my sig) it's best to start your own thread rather than bumping an old one.

Closed, PM me with any queries