Of the three medications that treat opioid addiction, one got more attention in the Florida Legislature this year.
More than $10.5 million was set aside for naltrexone, an expensive injectable medication that stops opioid cravings for up to 30 days.
Alkermes, the company that makes naltrexone under the brand name Vivitrol, spent more than $156,000 on campaign contributions in Florida during 2016, according to a report by Politico.
That includes Senate President Joe Negron, who received $50,000 from Alkermes.
According to Politico, Negron was instrumental in budget negotiations this year in getting funding for a program using Vivitrol. The report said the money for the treatments had been cut by the House, but Negron was successful in restoring it during private negotiations with the House Speaker.
Mary Lynn Ulrey, the CEO of the DACCO a treatment program in the Tampa Bay area, said she was surprised to see funding for the drug after the House had removed it.
"I think the Vivitrol folks are pushing it to the Legislature because I've never seen the head of the Senate so keyed up on doing something for addiction before, except he really loved this Vivitrol idea," Ulrey said. “I’m really happy if they like anything for drug treatment because sometimes it’s not really high on their list.”
Alkermes has been using similar techniques in states beyond Florida.
An investigation by NPR and Side Effects Public Media found that the drug maker is enlisting state and federal lawmakers to push its opioid treatment over others. In some cases, the NPR report found that Alkermes is contributing to misconceptions and stigma about other opioid treatment medications, such as methadone.
Ulrey said Vivitrol is only useful for treating patients who have been off of opioids for several weeks.
If an addict that uses heroin daily walks into a treatment center, she said, they need methadone, an opiod.
“You can’t give Vivitrol to somebody who is hyped up on drugs. They have to be clean,” Ulrey said. “If they are using drugs right now and I give them Vivitrol, it will throw them into detox and they will be miserable for days.”
Methadone sometimes gets a bad rap, she said, because it is an opiate. But it is still the gold standard in opioid treatment, she said. Its effects last 24 to 46 hours so addicts can get a daily methadone treatment, which stops cravings and allows them to function.
Counseling is also an important part of the treatment puzzle, Ulrey said.
Though Florida's Legislature made more money available this year for Vivitrol treatment, the final decision about what drug to use is up to the physicians, Ulrey said. Ultimately, she said, doctors will do what’s right for each patient.
“I do not think it will change the clinician’s view of what drug is right for the person that’s in front of them,” Ulrey said. “I’m gonna order what’s right for that person and I’m really glad that Vivitrol is one of the options that’s available.”