Understanding Addiction
and treatment options


Brain regions associated with dependence1

Dependence is thought to affect both the cortex and the limbic system.

Cortex and limbic systems This image is for illustrative purposes only.

Opioid and alcohol dependence are chronic, relapsing brain diseases that affect both the brain’s cortex and limbic system. Addiction can be devastating both psychologically and physically. While counseling can help patients work through the psychological aspects of dependence, medication may help address the physical changes in the brain.1

The Brain and Pleasure

Endorphin MOA This image is for illustrative purposes only.

The limbic system of the brain rewards us for doing life-sustaining activities by releasing endogenous opioids, for example beta endorphins, that attach to opioid receptors in the brain and stimulate the dopamine reward system.2-4 Questions remain about the endogenous opioid system as to the relationship between various opioid peptides and opioid receptors. Endogenous opioids can bind with mu (µ), delta (δ), and kappa (ϰ) opioid receptors.5

The brain and alcohol use

Alcohol MOA This image is for illustrative purposes only.

Drinking alcohol may cause an increased release of endogenous endorphins, which can bind to opioid receptors and stimulate the dopamine reward system. For some people, this increased dopamine release can cause them to seek out this feeling again and again.4

The brain and opioid use

Opioid MOA This image is for illustrative purposes only.

Heroin and prescription pain relievers are exogenous opioids. When they bind to mu opioid receptors in the brain, the resulting dopamine release can be 2–10 times greater than the dopamine release associated with natural pleasures. This excess of dopamine has a powerful reinforcing effect on the brain, which is why opioids have a high potential for abuse.1,6

The brain and chronic opioid use

Tolerance development with opioid use over time

Tolerance develops with chronic opioid use6

  • With repeated exposure, opioid receptors become less responsive to opioid stimulation.
  • More opioid is needed to stimulate the reward system to release the same amount of dopamine and produce the same amount of pleasure as before.
  • When an individual who is physically dependent on opioids suddenly stops using, they experience withdrawal symptoms.

VIVITROL is not right for everyone. There are significant risks from VIVITROL treatment, including risk of opioid overdose, injection site reactions and sudden opioid withdrawal.
See Important Safety Information below. Discuss all benefits and risks with your patients.
See Prescribing Information. Review Medication Guide with your patients.

Request A Representative


Request a visit from a VIVITROL representative
to learn more about how VIVITROL may help
your patients with opioid dependence and
alcohol dependence.


VIVITROL® Co-pay Savings Program


Learn how the VIVITROL® Co-pay Savings Program may assist eligible* patients with out-of-pocket expenses for their VIVITROL prescriptions.



  1. National Institute on Drug Abuse (NIDA). Drugs, brains, and behavior: the science of addiction. NIH publication 14-5605. https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/soa_2014.pdf. Revised July 2014. Accessed November 19, 2020.
  2. Esch T, Stefano G. The neurobiology of pleasure, reward processes, addiction and their health implications. Neuro Endocrinol Lett. 2004;25:235-251.
  3. Adinoff B. Neurobiologic processes in drug reward and addiction. Harv Rev Psychiatry. 2004;12(6):305-320.
  4. Herz A. Endogenous opioid systems and alcohol addiction. Psychopharmacology (Berl).1997;129(2):99-111.
  5. Meyer JS, Quenzer F. The opioids. In: Psychopharmacology: Drugs, the Brain, and Behavior. 2nd ed. Sunderland, MA: Sinauer Associates, Inc; 2013:305-337.
  6. Kosten TR, George TP. The neurobiology of opioid dependence: implications for treatment. Sci Pract Perspect. 2002;1(1):13-20.

*Terms and Conditions

Eligibility for Alkermes-Sponsored Co-pay Savings. This offer is only available to patients 18 years or older, with a prescription consistent with the Prescribing Information and the patient is not enrolled in, or covered by, any local, state, federal or other government program that pays for any portion of medication costs, including but not limited to Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care and Alternative Benefit Plans under the Affordable Care Act; Medigap; VA; DOD; TRICARE; or a residential correctional program.
Additional Terms of Use: This offer is not conditioned on any past, present, or future purchase, including refills. Alkermes reserves the right to rescind, revoke, or amend this offer, program eligibility, and requirements at any time without notice. This offer is limited to one per patient, may not be used with any other offer, is not transferable and may not be sold, purchased or traded, or offered for sale, purchase or trade. Void where prohibited by law. Program Administrator or its designee will have the right upon reasonable prior written notice, during normal business hours, and subject to applicable law, to audit compliance with this program.