Alcohol Use Disorder Treatment · Updated June 2026
Vivitrol for Alcohol Addiction
Once-monthly naltrexone injection to reduce alcohol cravings — prescribed and administered at our CARF-accredited injection clinics in Chattanooga and Cleveland, TN, and Ringgold, GA.
CARF AccreditedLicensed in Tennessee & GeorgiaSame-day appointments availableConfidential from your first call
At a glance
Who Vivitrol is best for
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Vivitrol (extended-release naltrexone) is for patients with alcohol use disorder who want a monthly injection alternative to daily oral medications. A single intramuscular injection blocks alcohol’s rewarding effects for approximately 28 days. Garbutt 2005 JAMA documented reduced heavy-drinking days in patients on Vivitrol. Patients must be opioid-free for 7-14 days before initiation to avoid precipitated withdrawal; liver-function testing is recommended at baseline given hepatotoxicity considerations.
At Restoration Recovery, Vivitrol is offered specifically for alcohol use disorder — not for opioid use disorder, where buprenorphine-based MAT (Suboxone, Sublocade, Brixadi) is our primary OUD pathway. Vivitrol injections are administered in clinic at our Chattanooga, Cleveland, and Ringgold clinics; Soddy-Daisy is oral-only, so those patients receive theirs at Chattanooga or Cleveland. Same-day first appointments; TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.
What Is Vivitrol?
Vivitrol is the brand name for extended-release naltrexone, an FDA-approved injectable medication used to treat alcohol use disorder. Unlike daily oral medications, Vivitrol is administered as a single intramuscular injection once per month at your provider’s office. This eliminates the need for daily pill compliance and provides a steady, consistent level of medication throughout the treatment period.
At Restoration Recovery, Vivitrol is prescribed specifically for patients with alcohol use disorder as part of a comprehensive outpatient treatment plan. The injection is given by a licensed provider during a brief clinic visit, and each dose provides approximately four weeks of continuous medication coverage.
How Vivitrol Works for Alcohol Use Disorder
Naltrexone, the active ingredient in Vivitrol, is an opioid receptor antagonist. While this may sound counterintuitive for alcohol treatment, the science behind it is well established. When a person drinks alcohol, the brain releases endorphins that bind to opioid receptors, producing feelings of pleasure and reward. Over time, this reinforcement cycle drives compulsive drinking behavior.
Vivitrol works by blocking the opioid receptors involved in this alcohol reward pathway. With these receptors blocked, drinking no longer produces the same pleasurable reinforcement. Patients on Vivitrol frequently report that their cravings diminish significantly and that alcohol simply becomes less appealing. With cravings quieter, it becomes easier to focus on counseling and the day-to-day changes that support recovery.
Safety Checks Before Your First Injection
Vivitrol is well-tolerated for most patients with alcohol use disorder, but two clinical checks happen before your first injection:
Liver function testing. Naltrexone is hepatically cleared, and the FDA label includes a boxed warning regarding hepatotoxicity at high doses. Your provider will review your liver-enzyme labs (AST, ALT, bilirubin) at intake. Patients with active hepatitis or significant hepatic impairment may be better candidates for Acamprosate, which is renally cleared and safer in liver disease.
Opioid-free interval. Naltrexone is an opioid antagonist, so injecting it while opioids are present in the body precipitates immediate, severe withdrawal. Patients who have been using opioids must be opioid-free for 7 to 14 days before the first Vivitrol injection. We screen carefully for this, and patients with co-occurring opioid use disorder are typically referred to Suboxone, Sublocade, or Brixadi instead.
Common side effects include injection-site reactions, nausea, headache, and fatigue, particularly in the first few days after a dose. Your provider will review the full safety profile and your individual medical history before your first injection.
Your options
Four FDA-Approved AUD Medications
Restoration Recovery prescribes all four FDA-approved medications for alcohol use disorder. They work through different mechanisms — some quiet cravings, one normalizes brain chemistry, one deters drinking outright — so your provider matches the medication to your situation at the first visit. Vivitrol is the once-monthly injection for patients who want craving reduction without a daily pill.
This medication
Monthly injection
Vivitrol
Extended-release naltrexone · 380 mg intramuscular injection once monthly
For reducing cravings and heavy drinking. A monthly injection that blocks the reward signaling alcohol activates — given in clinic, no daily pill to remember. Works well for patients in early cessation. Hepatically cleared, so liver health is a consideration, and patients must be opioid-free before the first injection. Administered at our Chattanooga, Cleveland, and Ringgold clinics.
Daily oral tablet
Acamprosate
Two 333 mg tablets, three times daily · taken with meals
For patients already abstinent who want to maintain it. A daily oral tablet that quiets the post-acute withdrawal symptoms driving relapse by normalizing glutamate/GABA balance. Renally cleared — often preferred for patients with liver disease. Available at all four clinics.
Daily oral tablet
Naltrexone (oral)
Daily oral naltrexone · the same blockade as Vivitrol, taken by mouth
For craving reduction without an injection. The same opioid-receptor blockade as Vivitrol in a daily pill rather than a monthly shot. A fit for patients who want naltrexone’s mechanism but prefer oral dosing. Available at all four clinics.
Daily oral tablet
Disulfiram
Daily oral tablet (Antabuse) · an aversive deterrent
For highly motivated patients with stable support. Taken daily, it produces an unpleasant physical reaction if you drink — a deterrent rather than a craving modulator. Most effective for patients who want a built-in reason not to drink and have support at home. Available at all four clinics.
Some patients combine two — for example, Vivitrol for craving reduction and acamprosate for ongoing maintenance. Vivitrol is an injection, so it is available at our Chattanooga, Cleveland, and Ringgold clinics; the three oral medications are offered at all four. For opioid use disorder we prescribe different medications — Suboxone, Sublocade, and Brixadi. For a side-by-side view of our five core MAT medications — Suboxone, Sublocade, Brixadi, Vivitrol, and acamprosate — see our MAT Medications Compared tracker.
The evidence
What the Research Shows on Vivitrol
Vivitrol is one of the most rigorously studied medications for alcohol use disorder. The pivotal Garbutt trial earned it FDA approval for alcohol dependence in 2006, the larger COMBINE study confirmed the mechanism across 1,383 patients, and more recent real-world data from the Department of Veterans Affairs tracked how patients actually do once they start treatment. The three findings below come from that body of research.
25%Fewer heavy-drinking days
Patients on the 380 mg monthly injection had a 25% reduction in heavy-drinking days versus placebo over six months. Garbutt JC et al. JAMA. 2005;293(13):1617–1625 — pivotal trial, 624 patients, 24 U.S. sites.
75 → 81%Days abstinent
Patients on naltrexone plus medical management were abstinent 81% of days versus 75% on placebo plus medical management. Anton RF et al. COMBINE study. JAMA. 2006;295(17):2003–2017. 1,383 patients, 11 U.S. academic sites. (Oral naltrexone; Vivitrol is the extended-release injection form of the same molecule.)
58 → 35%Hospitalized that year
Alcohol-related hospital admissions fell from 58% the year before treatment to 35% the year on Vivitrol — nearly a 40% relative reduction. Grebla R et al. Substance Use. 2024;18:29768357241280713. VA cohort, 3,665 patients.
What these numbers actually mean
One of the most evidence-backed options for alcohol use disorder
The Garbutt trial was the study that earned Vivitrol its FDA approval for alcohol use disorder. Patients receiving the 380 mg monthly injection experienced a 25% reduction in the rate of heavy-drinking days compared to those on a placebo injection, across a six-month treatment window. The larger COMBINE trial, published the following year in JAMA, tested naltrexone at scale: over 1,383 patients, those on naltrexone plus medical management were abstinent on 81% of days during treatment, compared to 75% on placebo plus medical management. COMBINE used oral naltrexone; Vivitrol is the extended-release monthly injection form of the same molecule, designed to eliminate the daily-pill adherence gap.
Real-world data have since validated the trial results at scale. A 2024 Department of Veterans Affairs cohort study tracked 3,665 patients initiating Vivitrol for alcohol use disorder; alcohol-related hospital admissions dropped from 58% the year before treatment to 35% the year on treatment — nearly a 40% relative reduction in inpatient care. The American Psychiatric Association’s 2018 practice guideline recommends naltrexone (including its extended-release injectable form) for moderate-to-severe alcohol use disorder at its highest evidence grade.
At Restoration Recovery, Vivitrol is prescribed alongside counseling, peer support, and ongoing medical check-ins. The injection reduces cravings; the counseling and monthly visits around it are what hold the change in place over time.
Full citations in References: Garbutt 2005 (JAMA), Anton 2006 (JAMA, COMBINE), Grebla 2024 (Substance Use, VA cohort), Reus 2018 (Am J Psychiatry, APA guideline).
Starting Vivitrol — Your First Appointment
Vivitrol treatment at Restoration Recovery follows the same four-step first-visit flow we use for all of our patients, typically lasting 2 to 3 hours and scoped toward your Vivitrol start. Because Vivitrol is ordered rather than stocked on-site, your provider places the order at this visit and your injection is scheduled as a short follow-up once the medication is approved.
01
Intake
Paperwork and a clinical intake — a DSM-5 assessment covering AUD criteria and severity, plus a review of your drinking history, current health, and relevant lab work, including liver-function labs.
02
Counseling
You meet with a counselor to discuss your drinking history, any prior treatment, current status, and your personal recovery goals — including whether a once-monthly injection fits your situation.
03
Doctor evaluation
A medical provider reviews your intake and counselor notes, confirms you have been opioid-free for the required interval, determines whether Vivitrol is clinically appropriate, and explains what to expect before, during, and after the injection.
04
Vivitrol order + injection scheduled
If Vivitrol is appropriate and you’re ready to pause drinking around the start of treatment, your provider orders it the same day. Because we don’t stock Vivitrol on-site, your injection is scheduled as a follow-up once the medication is ordered and approved — your care team will work with you on timing that fits your situation.
About 2–3 hours.Vivitrol ordered the same day; injection scheduled once the medication is approved.Bring a photo ID, your insurance card, and a list of any medications.
What ongoing monthly visits look like+
After your first visit, ongoing Vivitrol care is built around a monthly clinic visit. Each visit includes the monthly injection, administered in clinic by a licensed provider, plus a brief check-in — your provider assesses progress, manages any side effects, and adjusts your treatment plan as needed.
Counseling continues alongside the medication. Medication alone is not a complete treatment plan. Vivitrol is paired with individual counseling, peer support, and structured follow-up to address the behavioral, emotional, and situational factors that contribute to alcohol use disorder.
Common side effects of Vivitrol may include nausea, headache, fatigue, or soreness at the injection site; most are mild and temporary. Your provider reviews the full safety profile with you before your first injection. Anything you share during intake, counseling, or your monthly visits is protected by HIPAA and 42 CFR Part 2 — the federal rule that specifically shields addiction-treatment records from disclosure without your written consent.
Benefits of Vivitrol for Alcohol Addiction
Vivitrol offers several distinct advantages for patients managing alcohol use disorder:
Reduces alcohol cravings. By blocking the reward signals associated with drinking, Vivitrol helps patients experience fewer and less intense cravings over time.
Non-addictive. Vivitrol has no abuse potential and does not produce dependence. It can be discontinued at any time without withdrawal effects.
Once-monthly convenience. A single injection each month replaces the need for daily medication, which improves adherence and reduces the daily mental burden of treatment.
Clinically administered. Because the injection is given in the office, there are no pills to manage, misplace, or forget at home.
Supports long-term recovery. When combined with counseling and structured support, Vivitrol helps patients sustain the behavioral changes that lead to lasting sobriety.
Who Is a Candidate for Vivitrol?
Vivitrol may be appropriate for patients who meet one or more of the following criteria:
Adults diagnosed with alcohol use disorder who are seeking medication support for their recovery
Patients who are ready to pause drinking around the start of treatment and continue with counseling support
Individuals who prefer a once-monthly injection over daily oral medication
Patients who have difficulty with daily medication adherence
People looking for a non-addictive medication with no abuse potential
Your provider at Restoration Recovery will conduct a thorough evaluation to determine whether Vivitrol is the right fit for your situation. Not every patient with alcohol use disorder requires medication, and not every patient who does will be best served by Vivitrol — patients with significant liver disease, for instance, are often better suited to Acamprosate, and those still using opioids are referred to a buprenorphine-based pathway first. The goal is always an individualized treatment plan that reflects your clinical needs and personal goals.
Wondering if Vivitrol is right for you?
The first visit answers that. Your provider reviews your drinking history, liver labs, and goals, then walks through whether Vivitrol, an oral option, or a combination fits best. Same-day appointments at our injection clinics.
Why Patients Choose Restoration Recovery for Vivitrol
Vivitrol works best at a clinic built for long-term, in-person care. Because the injection is given in clinic each month, every dose is also a check-in with a provider who knows you. Here is what patients find at Restoration Recovery:
Three injection clinics across Tennessee and North Georgia. Vivitrol is administered in-clinic at Chattanooga, Cleveland, and Ringgold — so your monthly injection is also a built-in check-in with a provider who knows you. Our Soddy-Daisy clinic is oral-only; Soddy-Daisy patients route to Chattanooga or Cleveland for the injection on the same medical record.
MAT-certified providers and a CARF-accredited program. CARF (Commission on Accreditation of Rehabilitation Facilities) is the gold standard in addiction-treatment accreditation — a level of clinical scrutiny most outpatient clinics do not pursue.
One of Chattanooga’s longest-running outpatient clinics. Some of our patients have been with us for more than five years. Continuity matters in recovery.
4.6 stars across 49 verified Google reviews. Read a few before you call.
The full AUD medication formulary under one roof. Alongside Vivitrol, we prescribe Acamprosate, oral naltrexone, and disulfiram — so we can fit the medication to the patient, and switch or combine when that serves recovery better.
Integrated counseling and behavioral health in-house. Medication without counseling is only part of a treatment plan. We provide both under one roof, and treat co-occurring anxiety, depression, or trauma alongside recovery.
Most major insurance plans accepted. TennCare, Medicaid, Medicare, and commercial carriers. For most patients, out-of-pocket cost is minimal to none.
Confidential by federal law. Your treatment is protected under HIPAA and 42 CFR Part 2, which specifically shields addiction-treatment records from most forms of disclosure. What you share with us stays with us.
“I owe my entire recovery to this place. I had tried so many times in the past, but not until I found these guys did I succeed.”
CARF-accredited outpatient addiction care
TennCare, BlueCare, BCBS, UHC, Medicare & most commercial insurance accepted. We verify your benefits before your first visit — no surprises. Licensed in TN & GA · HIPAA · 42 CFR Part 2.
Insurance and Access
Restoration Recovery accepts most major insurance plans for Vivitrol treatment, including TennCare, Medicaid, Medicare, and a wide range of commercial insurance plans. Most plans cover Vivitrol for alcohol use disorder, and because the injection is office-administered, it is often billed under the medical benefit. Prior authorization is usually required, and TennCare members typically have $0 out-of-pocket. Our patient services team verifies your coverage before your first visit and explains any out-of-pocket costs so there are no surprises.
If you do not have insurance or are unsure about your coverage, contact us anyway. Self-pay for care at the clinic is a flat $250 per month. The Vivitrol medication is billed separately from that clinic fee — because the injection is office-administered, it is typically run through your insurance’s medical benefit, and our team will go over medication-cost options with you before anything is scheduled. To check your specific plan before you book, use our 2-minute insurance verification or visit our insurance page.
Ready to start Vivitrol?
Same-day appointments at our injection clinics. Call and our team will verify your insurance, confirm your safety checks, and get your first visit on the calendar.
Vivitrol is administered at three Restoration Recovery clinic locations across Tennessee and North Georgia. Each is staffed by providers experienced in alcohol use disorder treatment and medication-assisted care, with same-day appointments often available.
Vivitrol is an injection, so it is not given at our Soddy-Daisy clinic — Soddy-Daisy patients receive their monthly injection at the Chattanooga or Cleveland clinic, a short drive away, on the same medical record. Phones are answered Monday through Friday, 9am to 4:30pm Eastern. After hours? The 988 Suicide & Crisis Lifeline and the free, confidential SAMHSA National Helpline (1-800-662-4357) are available 24/7.
References
The statistics and clinical findings on this page come from peer-reviewed medical research and authoritative public-health sources. Patients, family members, and providers are welcome to verify any claim against the original source.
Garbutt JC, Kranzler HR, O’Malley SS, et al. Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. JAMA. 2005;293(13):1617–1625. [PubMed]
Anton RF, O’Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295(17):2003–2017. [PubMed]
Grebla R, Liu J, O’Sullivan AK, et al. Treatment Journey and Healthcare Resource Use Among Patients With Alcohol Use Disorder Who Initiated Extended-Release Naltrexone: An Analysis of Veterans Affairs Data. Substance Use. 2024;18:29768357241280713. [PubMed]
Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry. 2018;175(1):86–90. [PubMed]
Leighty AE, Ansara ED. Treatment outcomes of long-acting injectable naltrexone versus oral naltrexone in alcohol use disorder in veterans. Mental Health Clinician. 2019;9(6):392–396.
American Society of Addiction Medicine (ASAM) and U.S. Department of Veterans Affairs / Department of Defense (VA/DoD). Clinical Practice Guidelines for Substance Use Disorders. [VA/DoD]
VIVITROL (naltrexone for extended-release injectable suspension). Prescribing Information. Alkermes, Inc. Accessed via DailyMed, U.S. National Library of Medicine. [DailyMed]
Questions
Frequently Asked Questions
How does Vivitrol work for alcohol use disorder?+
Vivitrol is an extended-release naltrexone injection given once monthly. Naltrexone is an opioid antagonist that blocks the reward pathway alcohol activates, reducing the urge to keep drinking and blunting the pleasurable effects if relapse occurs. It does NOT produce an alcohol-aversion reaction like disulfiram (Antabuse); it simply reduces craving and the reward feedback loop. Evidence from the Garbutt 2005 JAMA pivotal trial showed 25% fewer heavy drinking days over 6 months compared to placebo.
Do I need to be completely abstinent before starting Vivitrol?+
You should not be actively drinking when you receive your first Vivitrol injection. Your provider will ask you to pause drinking so the medication can be started safely, typically at least a few days, though the exact duration depends on your individual history. This isn’t an absolute abstinence requirement like disulfiram; it’s a safety buffer. Many patients start Vivitrol after a brief period of reduced or stopped drinking and find the injection helps maintain abstinence from there.
Is Vivitrol used for opioid use disorder at Restoration Recovery?+
At Restoration Recovery, we use Vivitrol only for alcohol use disorder. Naltrexone is FDA-approved for both opioid and alcohol use disorder and some clinics use it for opioid. We’ve chosen to keep Vivitrol alcohol-only for reasons of clinical focus and patient safety — our opioid patients are best served by Suboxone, Sublocade, or Brixadi (all buprenorphine-based), which have a different safety profile and don’t require a prolonged opioid-free period before initiation.
What are the common side effects of Vivitrol?+
Common side effects include injection-site reactions (soreness, redness, bruising), mild nausea (especially in the first month), fatigue, and occasional headache. Most side effects resolve within a few days of the injection. Serious but uncommon issues include liver enzyme changes — your provider may order baseline liver function tests before starting. Vivitrol can precipitate severe opioid withdrawal if you’re currently using opioids (even prescription), which is why we use it only for alcohol use disorder at this clinic.
Does my insurance cover Vivitrol?+
Most insurance plans cover Vivitrol for alcohol use disorder, including TennCare (BlueCare, Wellpoint, UHC Community Plan), traditional Medicare, Medicare Advantage, and most commercial plans. Prior authorization is usually required. TennCare members typically have $0 out-of-pocket. Commercial copays vary — Vivitrol is often billed under the medical benefit since it’s office-administered. Our intake team verifies your specific coverage before your first injection. We don’t stock Vivitrol on-site; the injection is scheduled as a follow-up once the medication is ordered and approved. See our insurance page for carrier details.
What’s the difference between Vivitrol and Acamprosate for alcohol use disorder?+
Both are evidence-based treatments for alcohol use disorder, but they work through different mechanisms. Vivitrol (naltrexone) blocks the reward pathway — you feel less desire to drink and less reward if you do. Acamprosate (Campral) works on the brain’s glutamate/GABA balance, supporting maintenance of abstinence after you’ve stopped drinking by reducing post-acute withdrawal symptoms (anxiety, insomnia, mood lability). Many patients use them together; others do well with one. Vivitrol is a monthly injection; Acamprosate is a daily oral tablet taken three times a day.
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