VIVITROL® Provider Instructions and Medically Assisted Treatment (MAT)
Welcome to our guide for VIVITROL® providers and medically assisted treatment (MAT). This page offers essential instructions and best practices for administering VIVITROL®, along with other treatments and guides to support recovery from opioid and alcohol dependence. Ensure safe and effective patient care with our comprehensive resources.
Vivitrol Provider Instructions
Information for Providers on Medically Assisted Treatment (MAT)
Notice to Providers
The special waiver (e.g., a DATA-Waiver) is no longer required to treat patients with opioid use disorder (OUD).
All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for opioid use disorder in their practice if permitted by applicable state law. SAMHSA encourages practitioners to treat patients within their practices who require treatment for a substance use disorder.
SAMHSA offers tools, training, and technical assistance to practitioners in the fields of mental and substance use disorders. Find information on SAMHSA training and resources.
For Additonal Information on the Waiver Elimination (MAT Act)
A total of eight hours of training is required from certain organizations on opioid or other substance use disorders for practitioners renewing or newly applying for a registration from the DEA to prescribe any Schedule II-V controlled medications.
Vivitrol Provider Instructions
Vivitrol® Information and Injection Guide
This section provides essential guidance for healthcare providers on the administration of Medically Assisted Treatments (MAT), including details on Vivitrol® injections, a service offered by Recovery Mobile Clinic. It also includes information on other MAT options like buprenorphine and methadone, which are not provided by our clinic but are important components of addiction treatment.
What Is Vivitrol®?
VIVITROL's® is a long acting injection medication that is only needed once a month.
VIVITROL® is NOT ADDICTIVE and does not cause withdrawal. This eliminates any physical dependence allowing patients to stop using VIVITROL®, after their 12 to 18 month program, with ease.
Oral Naltrexone and IM VIVITROL® Injections
Recovery Mobile Clinic offers comprehensive resources and training for administering Oral Naltrexone and IM VIVITROL® Injections. These treatments are crucial for managing alcohol and opioid dependence by blocking the euphoric effects and feelings associated with alcohol and opioids.
Guidelines for Administering VIVITROL® Injections
Step 1. Patient Assessment:
- Verify insurance coverage as VIVITROL® is an expensive medication. Ensure that payment arrangements are in place. See "Buy and Bill" below*
- Ensure the patient has abstained from opioids for at least 7-10 days before initiating treatment with VIVITROL® to avoid precipitating withdrawal.
- Make sure that the patient has abstained from alcohol and stimulants for at least 24 hours.
- Conduct a thorough medical evaluation to assess suitability for VIVITROL®, including:
- Liver enzyme tests to check for liver function
- Kidney function test
- Pregnancy test must be done on all female patients. ***VIVITROL® is contraindicated with pregnancy.
- Patients with a history of Skin infections, MRSA, and Xylazine wounds have an increased risk of infection at the site of VIVITROL® injection.
- Some patients report feelings of anxiety or depression after a VIVITROL® injection. While these are listed side effects, they are generally not directly caused by the injection. Substance use often serves as a coping mechanism for dealing with stress and mental health issues. Losing this can lead to increased anxiety and depression. Encourage patients to join support groups, seek counseling, and explore healthy distractions. Discuss these options with the patient before administering the VIVITROL® shot.
***We recommend that a urine drug screen be performed before each and every VIVITROL® injection.
Step 2. Preparation and Administration:
- VIVITROL® is administered as an intramuscular injection once a month.
- Properly mix the medication using the supplies provided in the VIVITROL® kit to ensure the medication is in suspension form.
- Administer the injection in the gluteal muscle, alternating between the two buttocks each month.
- Warm the VIVITROL® kit to slightly higher than body temperature before administration.
- It should feel warm in your hand to ensure ease of administration and patient comfort.
Step 3. Post-Injection Care:
- Monitor the injection site for any signs of infection or reaction.
- Provide the patient with instructions on how to care for the injection site and what signs of complications to look out for.
- Immediately following the injection, patients are encouraged to massage the injection area to keep the muscle warm.
- Activities such as walking, climbing stairs, performing squats, or using a heat pad can aid with absorption.
- The most common side effect of the VIVITROL® injection is a feeling of a knot or bump at the injection site due to the large amount of medicine administered. Patients may become anxious about this, but it is not dangerous as long as there is no infection. Reassure patients and remind them to use heat and massage to alleviate discomfort.
Step 4. Ongoing Management and Support:
- Schedule the next injection and provide the patient with a follow-up appointment card at the time of the current injection
- Each shot must be 28 days (4 weeks) apart.
- Schedule follow-up phone calls 8 to 10 days after an injection to monitor the patient's progress.
- This is crucial for providing reassurance and support, especially during the first two months of treatment.
- Offer or refer for supplementary addiction treatment services, including counseling and support groups, to improve treatment outcomes.
- It is not uncommon for patients to experience breakthrough cravings towards the end of the month, typically from day 21 to 28.
- Providing an oral form of naltrexone for use during these times can be helpful.
- Duration of treatment: It is recommended that patients continue VIVITROL® treatment for 18 months
- Minimum of 12 months of treatment is required at Recovery Mobile Clinic.
Buy and Bill Program
What is Buy and Bill?
The Buy and Bill program is a widely-used method for managing provider-administered drugs, such as biologics, injectables, and other specialty medications that cannot be self-administered. These drugs are typically infused or injected by healthcare providers in settings such as physician’s offices, clinics, infusion centers, or hospitals.
In this process, providers purchase the medication directly from a wholesaler ("buy" part) and then administer the drug to the patient. After administration, the provider bills the patient’s health insurance for both the cost of the drug and the administration fee ("bill" part). This method is commonly used for outpatient drugs and is reimbursed by various health plans, including Medicare Part B and commercial insurance.
How it Works with VIVITROL®
For patients with commercial insurance, we facilitate the ordering of VIVITROL® through Iassist. Here's how it works:
- Order Through Iassist: We use Iassist to order Vivitrol, ensuring it is delivered directly to our office.
- Scheduling: Once VIVITROL® arrives, we schedule an appointment for the patient to receive their injection.
- Administration: VIVITROL® is administered once a month, with a minimum interval of 28 days between doses.
Important Note: Adhering to the 28-day interval is critical. Administering VIVITROL® even one day early will result in reimbursement denial.
By utilizing the Buy and Bill program, we ensure patients receive timely and effective treatment while managing the high costs associated with VIVITROL® and other specialty medications. For more information or to participate in the Buy and Bill program, please contact our office.
Additional Treatment Options
Buprenorphine and Injectable Options
Buprenorphine is a cornerstone in the treatment of opiate addiction. It helps reduce cravings and withdrawal symptoms, making it a critical element of opiate addiction management. Although Recovery Mobile Clinic does not provide buprenorphine services, we aim to support healthcare providers by offering information on how it can be integrated into treatment plans and where they can direct patients for these services.
Get started with this quick start guide for providers from the SAMHSA:
Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings from SAMHSA - PDF
Methadone Treatment Information
Methadone is another effective medication used to treat opiate addiction. It works by changing how the brain and nervous system respond to pain, which helps reduce withdrawal symptoms and the desire to use opioids. ***Please note that Recovery Mobile Clinic does not administer methadone, but we provide information to help providers understand its use and find appropriate treatment facilities for their patients.
Discover informational resources for you and your patients on Sublocade®
SUBLOCADE® (buprenorphine extended-release) is for the treatment of moderate to severe opioid use disorder in patients who have initiated treatment with a buprenorphine-containing product, followed by dose adjustment for a minimum of 7 days. SUBLOCADE® should be used as part of a complete treatment plan that includes counseling and psychosocial support.
For more information check the links below:
Supporting Recovery
Recovery Mobile Clinic is committed to enhancing the capability of healthcare providers to administer these treatments effectively. By providing the necessary resources and training, we aim to empower providers to deliver optimal care and support recovery in their communities.
For more detailed information on administering Vivitrol® and other treatment options, or to request training for your practice, please contact us. We are here to assist you in providing comprehensive care to those in recovery.
Schedule an Appointment to Shadow at Our Clinic
Discover how to integrate:
- Patient Selection
- Screening
- Buy and Bill
- Iassist Ordering
directly into your practice!
Join us for a comprehensive appointment shadowing session at our clinic. Witness these critical processes in action and learn from our experienced team how to effectively implement them in your office. This is your opportunity to enhance your service offerings and streamline your operations.
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