Opioids
Naltrexone (Vivitrol / Revia)
Street names: Vivitrol, Revia, Depot naltrexone
Overdose? Act now. Call emergency services — say "unresponsive, not breathing". Give naloxone for opioid-like signs. Hotlines
⚡What it does
- Full opioid BLOCKER — prevents any opioid high for 24 h (tablet) to a month (injection)
- Also reduces alcohol reward (Sinclair method)
⚠Key risks
- PRECIPITATED WITHDRAWAL if taken while opioids are in the system — must be fully detoxed first (7–10+ days)
- Blocks pain relief from opioids in emergencies — carry the Vivitrol card
- Overdose risk paradox: tolerance drops during blocking; using through the block escalates doses dangerously
- Hepatotoxicity at high doses (historic concern, rare at therapeutic)
✚Overdose signs
- (Rare alone) nausea, headache; the danger is the post-treatment relapse overdose
📋Quick facts
Also known asVivitrol, Revia, Depot naltrexone
CategoryOpioids
Schedule / classNot controlled — Rx-only
Appearance50 mg tablets; 380 mg monthly injection (Vivitrol)
Street price~$1–$3 per tablet; injection $1,000+ (insurance covers in US)
Legal statusRx-only everywhere; standard medication for opioid and alcohol use disorder
Last updated2026-09-18
Sources: FDA, EMA, SAMHSA
Category comparison — Opioids
| Substance | Class | Top risks | Street price |
|---|---|---|---|
| Naltrexone (Vivitrol / Revia) | Not controlled — Rx-only | PRECIPITATED WITHDRAWAL if taken while opioids are in the system — must be fully detoxed first (7–10+ days); Blocks pain relief from opioids in emergencies — carry the Vivitrol card | ~$1–$3 per tablet |
| Suboxone (buprenorphine/naloxone) | Schedule III | Dependence (milder than full opioids); Precipitates withdrawal if taken too soon after other opioids | ~$10–$25 per 8 mg film |
| Naloxone (Narcan) | Not controlled — OTC | Short half-life (30–90 min) vs fentanyl's hours — the person CAN RE-OVERDOSE as it wears off. Stay and repeat; Precipitates withdrawal in dependent users — expect anger, vomiting, pain (they're alive — that's the point) | US OTC ~$45 |
| Methadone | Schedule II | Accumulates over days — overdose risk highest in first 2 weeks; Fatal mixing with benzos/alcohol | ~$10–$40 per 40 mg diskette |
Street prices are regional estimates. Potency and cuts vary constantly.
?Frequently asked questions
What does Naltrexone (Vivitrol / Revia) look like?
50 mg tablets; 380 mg monthly injection (Vivitrol)
What are the signs of a Naltrexone (Vivitrol / Revia) overdose?
(Rare alone) nausea, headache; the danger is the post-treatment relapse overdose Call emergency services immediately and give naloxone if available — it reverses opioid overdoses.
How addictive is it?
PRECIPITATED WITHDRAWAL if taken while opioids are in the system — must be fully detoxed first (7–10+ days) Dependence can develop with regular use.