Sunday, October 6, 2013

Judges in Ohio use injections to combat drug addiction

Matthew T. Mangino
The Youngstown Vindicator
October 6, 2013

Some Ohio judges are using a controversial and expensive injection therapy to battle drug addiction. Several years ago the Food and Drug Administration approved the use of a drug injected once a month, known as Vivitrol. The injections block receptors in the brain and prevent a person from getting high.

Vivitrol is a derivative of Naltrexone developed about 30 years ago to prevent heroin relapses. The government approved Naltrexone to treat heroin addiction in 1984 and for alcoholism in 1994.

Naltrexone was developed in the form of a pill. However, the pill required a measure of discipline, as it needed to be taken daily. By the 1990s, a federal nonprofit agency, the National Institute on Drug Abuse, funded research to develop an injectable form of the drug, reported the St. Louis Post-Dispatch. Vivitrol is that drug.

A study conducted in Russia with 250 heroin addicts, demonstrated that Vivitrol reduced relapse and prevented narcotic cravings. Vivitrol is not addictive, unlike other anti-addiction drugs, such as methadone and buprenorphine. Those medicines are used to replace heroin or other opiates with a more benign form of addiction.

Positive results

In the Russian study, after six months, 86 percent of patients taking Vivitrol were drug-free, going to counseling sessions and functioning in a job or at school, compared to 57 percent of those who did not receive the drug, reported National Public Radio.

The drug has gotten the attention of judges who must deal with the soaring recidivism rate of drug- addicted offenders.

A Vivitrol drug court in Hocking County currently has 10 people, with a waiting list to enter the program. The court follows accepted drug court protocols as established in jurisdictions across the country. “It is an intensive program. These people here are success stories,” Hocking County Municipal Court Judge Fred Moses told the Logan Daily News.

Near San Diego, Calif., the North County Drug Court program is also experimenting with Vivitrol. The drug is expensive so participation in the program is capped at 10 people. The pilot is one of a number of studies across the country. Maryland is using Vivitrol to help drug-addicted inmates transition back into the community. There are pilots in Massachusetts, Ohio, Pennsylvania and New York’s Rikers Island jail, reported the San Diego City Beat.

In Pennsylvania, Vivitrol has been court-ordered. Fayette County Judge Steve P. Leskinen has ordered offenders to use Vivitrol with moderate success. Next month the Pennsylvania DUI Association will present on the use of the drug in diverting criminal prosecutions.


Judge Robert Peeler of Warren County, Ohio, had three defendants die of heroin overdoses after he released them from jail. “They died because I released them. It’s impossible to keep them all in jail,” he told the Cincinnati Enquirer.

As a result, Peeler took the unprecedented act of ordering soon-to-be released defendants to undergo a series of nine to 12 injections of Vivitrol. He ordered some to receive the first injection while in jail.
Not everyone is sold on Vivitrol. Statistics from the Ohio Department of Mental Health and Addiction Services showed that 60 percent of addicts who treated with methadone stayed opiate-free. According to the Enquirer, the 2011 pilot program in Warren County found that inmates treated with Vivitrol injections had only a 25 percent success rate.

The real concern is the cost. If the first shot is administered while the inmate is still in jail the county will be responsible for the cost. Vivitrol will cost Ohio taxpayers about $1,100 per injection. The real question is will those injections reduce jail costs, court costs and the cost and suffering that comes from future victimization?

Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly and George and the former district attorney for Lawrence County, Pa. You can read his blog at and follow him on twitter @MatthewTMangino.

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