Substance guides

Vivitrol for alcohol: How the monthly shot reduces drinking

Published July 16, 2025 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Vivitrol is a once-monthly injection of naltrexone that reduces alcohol cravings and the pleasure from drinking. It eliminates the daily adherence challenge of oral naltrexone.

How it works

Naltrexone blocks opioid receptors involved in alcohol reward. Drinking on Vivitrol produces less pleasure, gradually weakening the brain's association between alcohol and reward. Over time, cravings decrease and drinking reduces.

Effectiveness

Clinical trials show Vivitrol reduces heavy drinking days by 25% compared to placebo. Combined with therapy, outcomes improve significantly. Some patients achieve complete abstinence; others achieve significant reduction.

Practical considerations

Monthly injection at a healthcare provider's office. Injection site reactions are common but manageable. Cannot use opioid medications while on Vivitrol. No detox or abstinence period required before starting (unlike Vivitrol for opioids). Cost: $1,000-$1,500/month; most insurance covers it.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

Does Vivitrol work for alcoholism?

Yes. Vivitrol reduces heavy drinking days by 25% vs placebo and is more effective combined with therapy.

Can I still drink on Vivitrol?

You can physically drink, but alcohol produces less pleasure. This is how the treatment works, gradually reducing the reward from drinking.

How long do you stay on Vivitrol for alcohol?

Duration varies. Many patients benefit from 6-12 months. Some continue longer. Discuss with your prescriber.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.