A once-monthly shot has injected new life into a Massachusetts physician’s network of family practices. Long an advocate of medication treatments as part of a comprehensive approach to fighting addictions, Punyamurtula S. Kishore, MD, MPH, says the injectable formulation of naltrexone that is marketed as Vivitrol has transformed his practice, encompassing 33 locations in the state.
"This one stands head and shoulders above the other medications," says Kishore, who in early 2009 wrote an article for the Addiction Professional website on blending Western and Eastern aspects of healing in treating the addict. Kishore says patients he has worked with report rapid improvements after the first intramuscular injection of the drug, talking of a return to feeling normal without experiencing alcohol cravings.
The November/December 2008 cover story in Addiction Professional focuses on how the maker of Vivitrol has enlisted numerous field leaders to spread the word about the medication to colleagues, in an effort to improve on a history of lackluster marketing of other anti-addiction drugs (including oral naltrexone itself).
Kishore sees Vivitrol as a tool for making behavioral therapy more effective. "There is no point in educating the patient until the biology has cooled down," he says.
Kishore says word has traveled fast in the Massachusetts recovery community about the injectable medication option. In addition, several primary addiction programs in the state have begun referring patients to Kishore’s Preventive Medicine Associates locations. About 90% of his patients on naltrexone are taking the injectable formulation, he says. Practically the only impediment to a complete switchover to Vivitrol, he believes, are insurance barriers, as one major HMO in Massachusetts still does not reimburse for Vivitrol prescriptions.