Vivitrol and Alcohol: What Happens If You Drink—and How MAT Fits Into Real Recovery

Last Updated on August 5, 2026

Vivitrol basics: the monthly shot for alcohol and opioid use disorders

Vivitrol is the brand name for an extended‑release, intramuscular form of naltrexone. It is given as a 380‑mg injection into the gluteal muscle once every four weeks by a medical professional.

Naltrexone is an opioid antagonist. It attaches to opioid receptors in the brain without activating them. That blockade reduces the rewarding effects that alcohol and opioids usually produce and helps decrease cravings.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), extended‑release naltrexone is approved to treat both alcohol use disorder (AUD) and opioid use disorder (OUD). It is not an opioid, it is not addictive, and it does not cause withdrawal when stopped.

The official prescribing information states that Vivitrol is indicated for alcohol dependence in adults who are able to abstain from drinking before their first injection. It is meant to be used as part of a comprehensive program that includes counseling and psychosocial support—not as a stand‑alone fix.

If you want a deeper dive into the science and side‑effect profile.

Naturally, many people want to know more than just the pharmacology. They want to know what it actually feels like if they keep drinking.

Related Nova resource

For a broader look at this medication beyond the injection, you can learn more about naltrexone and Vivitrol at Nova.

What actually happens if you drink alcohol while on Vivitrol?

Vivitrol does not act like a chemical “off switch” for alcohol. If you drink while on the medication, several things can happen at once.

1. The “buzz” may feel blunted—but impairment is still real

Because Vivitrol blocks opioid receptors that help mediate the brain’s reward response to alcohol, many people report less euphoria or “buzz” when they drink. You may feel like alcohol is doing less for you emotionally.

That does not mean alcohol stops affecting your body. Your blood alcohol level still rises. Your coordination, reaction time, decision‑making, and driving ability can be just as impaired as they would be without the medication. You can still black out, injure yourself, or harm others while intoxicated.

2. You might try to “drink through” the blockade

Some people on Vivitrol become frustrated that they do not feel the same buzz and start drinking more to chase it. That can lead to:

• Higher blood alcohol levels than usual
• Greater risk of alcohol poisoning and accidents
• Serious consequences for work, school, and relationships

In other words, the shot may change how rewarding alcohol feels, but it does not make heavy drinking safe.

3. Your liver still has to do the work

Naltrexone itself can stress the liver in some people, especially at higher doses or in those with liver disease. The prescribing information recommends monitoring for symptoms of hepatitis and stopping the medication if significant liver injury appears.

Alcohol already puts a heavy load on the liver. Combining ongoing heavy drinking with Vivitrol can increase the risk of liver problems, especially if you already have elevated liver enzymes, hepatitis, or cirrhosis. Your provider will usually order periodic lab tests to track how your liver is tolerating both alcohol history and medication.

4. Drinking on Vivitrol can confuse your goals

Finally, drinking while on Vivitrol can blur the line between “harm reduction” and “staying stuck.” Some people use the medication to help them cut back while working toward abstinence. Others find that continuing to drink keeps them trapped in the same patterns, just with slightly fewer cravings.

That is why honest conversations with your provider and treatment team are essential. The medication should support your goals—not replace them.

For clinicians and patients who want the original technical details, the FDA’s prescribing information explains how Vivitrol is dosed and monitored in adults with alcohol dependence.

Is Vivitrol really a “shot to stop drinking”?

Search phrases like “shot for alcoholism,” “shot to stop drinking,” or “injection to stop drinking” capture a real desire: people want one decisive step that makes alcohol a non‑issue. Unfortunately, no injection can do that.

Vivitrol helps by making alcohol less rewarding and by decreasing cravings over time. It does not:

• Erase urges to drink altogether
• Physically prevent you from picking up a drink
• Guarantee abstinence or protect you from consequences if you drink

Another medication, disulfiram (often known by the historical brand Antabuse), works differently. It creates an unpleasant reaction if alcohol is consumed, and some people picture that as a more dramatic “shot to stop drinking.” In reality, disulfiram is taken as a tablet—not an injection—and it also works best inside a full treatment plan.

If you want to understand how that deterrent medication compares, Nova has a separate resource that explains disulfiram in depth and clarifies how it differs from Vivitrol. You can read that Antabuse (disulfiram) guide.

The bottom line: Vivitrol is a powerful tool, not a cure. It helps change the odds in your favor while you do the harder work of recovery—learning new coping skills, rebuilding your life, and staying connected to support.

How Vivitrol fits into medication‑assisted treatment (MAT)

Medication‑assisted treatment is an evidence‑based approach that combines FDA‑approved medications with counseling and behavioral therapies. For alcohol use disorder, first‑line options include naltrexone (oral or injectable) and acamprosate; disulfiram may be appropriate for select people.

MAT is not about replacing one drug with another. Medications stabilize brain chemistry, reduce cravings, and lower relapse risk so that people can fully participate in therapy, peer support, and life changes.

Vivitrol’s role in an AUD treatment plan

In the context of MAT, Vivitrol can help people who:

• Have moderate to severe alcohol use disorder
• Can safely stop drinking long enough to start the injection
• Want a once‑monthly option instead of a daily pill
• Are willing to pair medication with therapy and recovery work

A typical plan might include medical detox if needed, starting Vivitrol once it is safe, engaging in counseling and group therapy, and building a relapse‑prevention plan that continues after formal treatment ends.

To see how Nova structures this kind of care, you can explore our Medication‑Assisted Treatment (MAT) programs in Texas.

If you want more detail on how different medications fit into alcohol treatment, the SAMHSA guide to medications for alcohol use disorder summarizes indications, precautions, and treatment‑planning considerations.

Is Vivitrol medication right for you?

Deciding whether to start Vivitrol should always be a shared decision with a medical professional who knows your history. Some general factors often come up in that conversation.

People who may benefit

• Adults with alcohol use disorder who have difficulty staying sober on therapy alone
• People who prefer a non‑addictive medication and dislike daily pills
• Individuals who have already completed detox or can safely stop drinking first
• Those who are committed to ongoing counseling and recovery support

Clinical reviews have found that naltrexone can reduce heavy drinking days and support abstinence when combined with psychosocial treatment.

When Vivitrol may not be appropriate

Vivitrol is generally avoided or used with great caution if you:

• Are currently using opioids or need opioid pain medication
• Have acute hepatitis or significant liver impairment
• Are pregnant, planning pregnancy, or breastfeeding without specialist input
• Are younger than 18, since safety has not been established

Guidance from SAMHSA and the prescribing information both stress that people must be opioid‑free for 7–10 days before starting naltrexone and that liver function should be checked before and during treatment.

Because every situation is unique, an honest conversation with a clinician who understands addiction medicine is essential before starting or stopping this medication.

Common questions about drinking on Vivitrol

“Will I get sick if I drink on Vivitrol?”

Unlike disulfiram, Vivitrol is not designed to make you violently ill if you drink. You may still feel side effects from the medication itself—such as nausea, fatigue, or headache—and any physical sickness from drinking (like hangovers) will still occur. But there is no built‑in “poisoning” reaction meant to punish you for drinking.

“Will I still feel drunk?”

Yes. Vivitrol acts mainly on the reward pathways, not on blood alcohol levels. You can still feel coordination problems, slowed thinking, and impaired judgment. Driving or operating machinery after drinking remains dangerous, with or without the medication.

“Can I use opioids while on Vivitrol?”

No. Vivitrol blocks opioid receptors. If you try to use opioids, you may not feel the expected effect and might take more, which can lead to overdose, coma, or death—especially as the medication wears off and your tolerance has dropped. The FDA label specifically warns about overdose risk at the end of a dosing interval, after missed doses, or after attempts to overcome the blockade.

Always tell every medical provider you see that you are receiving Vivitrol, and carry an updated medication list with you.

How Nova Recovery Center supports real recovery—not just a medication

Medication like Vivitrol can be a turning point, but it works best inside a structured recovery path. At Nova Recovery Center, that path can start with safe medical detox, move into residential care, and continue through outpatient and aftercare support so you are not doing this alone.

If you need help getting off alcohol or opioids safely before starting a medication such as Vivitrol, our medically supervised Austin detox program focuses on comfort, safety, and a smooth transition into the next level of care.

Some people benefit from 24/7 structure while they stabilize physically and emotionally. Our Wimberley inpatient rehab and Austin residential inpatient rehab programs weave together clinical care, 12‑Step work, peer support, and relapse‑prevention planning. Medication‑assisted treatment can be integrated when it fits your needs and goals.

Wherever you are with Vivitrol—curious, about to start, or already drinking on the medication—your situation is not hopeless. With the right combination of medical care, therapy, community, and accountability, it is possible to build a life where alcohol no longer runs the show.