Several years ago, most never even knew what Vivitrol was. Now, as medication-assisted treatment becomes more popular throughout the treatment community, the name Vivitrol is a common reference along with its counterparts, Suboxone and Methadone. Originally the drug was manufactured for those suffering from alcoholism, and was prescribed in a pill formation, otherwise known as Naltrexone. While the medication had the ability to suppress cravings associated with opiate addiction, its pill form came with several drawbacks for the opioid addicted population.
Soon, a small biotech company outside of Boston, went to work addressing those concerns. One major issue associated with Naltrexone is the matter of withdrawal. A patient must be completely abstinent from opiates before taking this medication, otherwise the individual may suffer precipitous withdrawal. In other words, they feel symptoms of withdrawal, both faster and stronger. So, before even being prescribed this medication, a user must undergo a detoxification process, which is often times very painful and uncomfortable. The other issue lies within the pill itself. After a patient completes detox, they then have to commit to taking a pill every day, that doesn’t even make them feel better. Naltrexone’s purpose is not to curb withdrawal symptoms, like other drugs such as Suboxone, but to instead stop cravings all together.
So, for the biotech company, the question remained. How do they get a patient to commit to such a process? The answer was to create a new formulation that didn’t require daily ingestion. And thus, the birth of Vivitrol.
Not Your Usual Consumer Market
Although Alkermes, the maker of Vivitrol, was able to design a new medication for the treatment of opioid addiction, they were met with much resistance. Yes, Vivitrol was accepted by some medical experts, but others still preferred older methods, such as Suboxone and Methadone. This was largely due to the painful detoxification process a patient would have to endure before eligibility of the injection. The other concern was with the high price tag of Vivitrol, topping out at $1,000 for a 28-day injection.
Due to this resistance, Alkermes knew traditional marketing tactics to physicians and treatment providers would not work. So, they went another route; one where choice was removed from the patient, and conveniently enough, where doctors were not involved. The company quickly began pitching their “miracle drug” to drug courts and judges across the country.
Initiated in the 80s, drug courts combine treatment with the structure of the judiciary system for repeated offenders. Rather than having to serve time in jail or prison, a repeated drug offender is given the opportunity to receive treatment for their addictive disease, while being monitored by a judge and/or drug court panel. The purpose is to reduce recidivism and have the individual achieve lasting sobriety. Today, there are more than 3,000 drug courts throughout the country, where tens of thousands of offenders are diverted to. For Alkermes, it has become a perfect market.
The pharmaceutical company has even gone as far to assign sales reps to specific drug courts in various counties across the country, and provide free injections to inmates who are scheduled to be released from prison within a month. While Medicaid does not cover medical care for inmates, it will usually pick up the tab for those who wish to continue with the injection.
The exploitation of judges and drug courts has paid off for Vivitrol manufacturers, with their sales continuing to skyrocket. The New York Times tells us, in 2012, only 15 programs were utilizing Vivitrol in a total of nine states. By April of 2017, the drug was used in 450 programs in 39 states. Additionally, Alkermes saw a 33% increase in their first quarter of 2017, compared to the previous year, reaching $58.5 million in total profits. Roughly half of those profits were paid through Medicaid programs, the most common insurance policy among drug court offenders.
Judges Now Playing Doctor?
By focusing their efforts on drug courts and lawmakers, Alkermes has indirectly removed the expert opinion of physicians and laid the power into the hands of judges. Mark Willenbring, an addiction psychiatrist in St. Paul, Minnesota says it best, “In what other medical situation do judges prescribe specific treatment from the bench? If you get in a car crash because you’re diabetic, do they prescribe a specific medication from the bench? This is the only area in medicine or health care where judges think they know more than doctors.”
As judges begin taking on this role, not only are they putting drug users at risk, but they are also forcing them into something they may not be comfortable with. NPR recently featured a story about a man by the name of Philip Kirby. Kirby had struggled with heroin addiction for quite some time, and after being arrested for drug-related charges, he entered a drug court program in Indiana. Nevertheless, before he could enter, the court pressured him into getting a shot of Vivitrol. Soon, Kirby suffered multiple side-effects, including sinus issues, chest problems, and a rash that eventually turned into white splotches on his body. Although he discussed these symptoms with the court, they encouraged him to continue the medication for a few more months.
Judge Gail Bardach of the Hamilton County drug court in Indiana said, “We encourage it, but we never force anybody.” But, Kirby felt anything but encouraged. “They made it seem like they were forcing it upon me, like I couldn’t come into the program until I got,” he remarks.
He went on to tell NPR that he wished he never taken Vivitrol in the first place.
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With 45 years of experience, we have learned that addiction treatment is not “one-size-fits-all.” That is why, when a suffering individual comes to us for help, we assess all of their specific needs and create treatment plans on an individualized basis. By doing so, we are able to provide them with the most effective solutions that have proven to work.
If you or someone you love is currently struggling with opiate addiction, please know there is another solution, and it can be found at Clearbrook Treatment Centers. If you are tired of being a hostage to your addiction, please contact our Admissions Specialists today and see what recovery has to offer.