Trump’s Opioid Plan Could Mean Big Business for Vivitrol Makers

By Kelly Burch 03/30/18

Controversy surrounding the medication did not stop the president from prominently featuring it in his opioid plan.

Donald Trump

President Trump’s opioid plan calls for federal inmates who have substance use disorder to be treated with naltrexone, a specific type of medication-assisted treatment (MAT), which is sold by only one company. 

Naltrexone is sold under the brand name Vivitrol and manufactured by the Massachusetts-based company Alkermes. The company has come under criticism for its allegedly aggressive marketing practices, which portray Vivitrol as a better type of medication-assisted therapy, despite the fact that studies have shown Vivitrol and the alternative medication Suboxone (which contains buprenorphine) are equally effective at treating opioid addiction.

Last November, California Democratic Senator Kamala Harris announced an investigation into Alkermes’ marketing practices.  

However, controversy over the drug did not stop the Trump administration from writing it into the opioid response plan. The plan calls on federal prisons to “facilitate naltrexone treatment and access to treatment,” clearing the way for thousands of inmates to receive expensive Vivitrol injections paid for by the government. 

Although the move to increase access to medication-assisted treatment is laudable, healthcare leaders say that which medication is used should be directed by doctors considering their patients’ needs, rather than by policy. 

“We don’t per se favor one drug over the other, because some patients respond better to one or the other,” said Nora Volkow, the director of the National Institute on Drug Abuse, at a press event on Tuesday, according to STAT News. “It is clear that treatment in the prison system significantly improves outcomes, whether it’s [with naltrexone or buprenorphine].” 

When questioned about why the plan specifically called for treatment with naltrexone, Health Secretary Alex Azar initially seemed to think it was an oversight. 

“I have a feeling that was an inadvertent reference. I think the key thing was the prison population, as opposed to any one product,” he told STAT News.

However, he later clarified that the plan would, in fact, dictate treatment with naltrexone, saying federal policy states anyone “coming out of prison or a detox program should in fact be put on naltrexone, but that doesn’t mean it’s the best form [of MAT] for all populations.”

Vivitrol has become a popular treatment option, especially in the prison system, because it does not contain opioids. In addition, it is given in a shot, making it less likely to be misused or diverted for illegal consumption. The drug blocks a user's high from opioids, which some people feel is morally superior to treating opioid addiction with drugs like methadone and buprenorphine that contain opioids. 

However, Leo Beletsky, a professor of law and public health at Northeastern University who focuses on drug policy, said that the focus on Vivitrol is just another form of stigma against medication-assisted treatment. 

“Methadone and buprenorphine have been shown on a variety of metrics to be far superior to Vivitrol—that includes safety, effectiveness, and cost,” he said. “The reason Vivitrol is preferred is that it’s a medical version of forced abstinence. That is why it’s been the darling of those who rhetorically support medication assisted treatment.”

Please read our comment policy. - The Fix
Kelly Burch Contrib.jpg

Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.