What the anti-alcohol injection is and how naltrexone works
Let us start by sorting out the names, because two different medicines circulate online under the same label. The anti-alcohol injection we are describing is extended-release naltrexone, sold under the name Vivitrol. This is an entirely different preparation from disulfiram, which is implanted under the skin, and it is exactly this difference that shapes the whole course of treatment and the tests it calls for.
How naltrexone quiets alcohol craving
Naltrexone is an opioid receptor antagonist. It occupies the sites in the brain through which alcohol releases the feeling of pleasure and relief. When drinking stops being rewarding, the alcohol craving, that nagging urge to reach for a glass, weakens over time. The medicine sets off no violent reaction after drinking and it is not addictive. The implant works in exactly the opposite way, through fear of poisoning.
What extended release of naltrexone means
In this form naltrexone is sealed in microspheres from which it releases slowly. A single injection therefore works for about a month, and the patient does not have to remember a daily tablet. The same substance in depot form is also used to prevent relapse in opioid dependence, but in Lodz we are mainly interested in its role in treating alcoholism.
Why the injection is part of treatment, not the entire course
The 380 mg dose is given as a deep intramuscular injection into the buttock, once every 4 weeks, and it is always administered by medical staff. Naltrexone is not, however, a standalone treatment. It works best as part of a treatment plan that leaves room for therapy and the support of loved ones. That is why we treat it as one of the tools in the plan, not a way to settle the problem with a single jab.
Why we do not give the injection without qualification and tests
In our approach the qualification is the heart of the matter, which is why we start there rather than with the injection itself. Naltrexone has real contraindications and, given without checking, it can do harm, so treatment opens with a qualifying visit at the clinic on Rogozińskiego.
The medical interview and the question about opioids
The doctor asks about the drinking history, earlier attempts at treatment, chronic illnesses and every medicine being taken. One question is crucial: whether the patient takes any opioids. Naltrexone and opioids rule each other out, and this also covers painkillers and cough medicines that contain opioids, as well as substitution treatment. Separately, the doctor assesses mood and mental state, because an alcohol problem often goes hand in hand with low mood.
Which tests we order before the injection
As standard we order a blood count, liver function tests and tests for hepatitis B, hepatitis C and HIV. Women of childbearing age take a pregnancy test, because the medicine is not given during pregnancy. If opioid use is suspected, a urine test is added. The liver tests are here for a reason: naltrexone is metabolised in the liver, and in severe liver disease the injection must not be given.
Talking through the risk and informed consent for the injection
Before the patient decides, we go over the alternatives, the limits of the medicine and the most important risk, namely the loss of opioid tolerance. This is the moment for questions, including the awkward ones. Only after such a conversation and informed consent do we arrange to bring in the medicine, because without understanding what the patient is agreeing to there is no point in starting.
When the injection has to wait
If the patient is in the middle of a drinking binge or in active withdrawal, they first have to be safely detoxed. We then start with alcohol detox in Lodz, and we return to qualifying for the injection once the body has been cleared.
The greatest risk of naltrexone: opioid tolerance and contraindications
Naltrexone is a well-understood medicine, but like every drug it carries risks. A few of them have to be known before the decision on the first injection is made, because they are what determines who may receive the drug.
Risk of opioid overdose after the injection
Let me begin with the most important warning, because it weighs most with this medicine. Naltrexone blocks opioid receptors, so while it is working the body gets used to being without opioids and loses its tolerance to them. This state persists even after treatment ends. If someone then tries to override the blockade with a larger dose of an opioid, or simply goes back to the dose from before therapy, they risk respiratory arrest and, in the extreme, death. For this reason all opioid medicines are stopped for at least 30 days from the last injection, and we advise the patient to carry information about the treatment, so that a paramedic or anaesthetist knows about it before giving anything.
Injection-site reactions, the liver and mood
At the injection site there can be pain, hardening or swelling, and very rarely more serious changes that need a surgeon's help. Naltrexone can also strain the liver, so we watch for jaundice, dark urine and abdominal pain. The more common, usually mild symptoms include nausea, headache, fatigue and muscle and joint aches. We also keep an eye on mood, because in people with an alcohol problem the risk of it dropping is raised anyway.
Who cannot receive the injection
The injection is not given to people taking opioids or in active withdrawal, to pregnant women, or in acute hepatitis or severe liver failure and in the case of allergy to naltrexone. Caution is needed with a planned operation that would call for opioid painkillers. This list is precisely why qualification and tests are not a formality with us. Without them we simply do not give the medicine.
Targeted import of Vivitrol and the legality of the injection in Lodz
The question of legality comes up at almost every qualification, and the answer depends on which medicine is meant. Online, the phrase anti-alcohol injection most often describes a disulfiram injection, and it is that one which has no marketing authorisation in Poland or across the whole European Union. The preparation we use is extended-release naltrexone, and bringing it in is done legally, only not on an ordinary prescription.
Targeted import as the legal route to the medicine
Vivitrol has no Polish registration, but the law allows it to be brought in for a specific patient under the targeted import (Polish "import docelowy") procedure. The same route has for years brought other medicines unavailable locally into Poland. The doctor files the request electronically in a government system, a consultant confirms it, and the Minister of Health grants permission to import the medicine. The indication is alcohol dependence. There is no grey area here, though you have to reckon with a few weeks of waiting.
How long targeted import takes and how the medicine is stored
After the minister's approval, the medicine is ordered through an ordinary pharmacy, which brings it in from a wholesaler. A prescription for targeted import is valid for up to 120 days, so the order has to be timed well. Vivitrol needs cold storage, it is kept at 2 to 8 degrees Celsius, and before administration it has to warm up to room temperature.
Is the injection reimbursed
In theory reimbursement is possible, because a patient has the right to file a separate application to the Minister of Health to cover the cost of a medicine from targeted import. In practice, however, no such approvals for Vivitrol in the treatment of alcoholism have been issued so far, and the AOTMiT Transparency Council that gives opinions on them found in 2022 that reimbursement was unjustified. That is why we assume the patient pays for the medicine, and we say so plainly before the procedure begins.
What happens on the day of the injection and how long therapy lasts
The procedure itself takes a moment. But it is the day of the injection and the length of the whole treatment that patients ask about most, so I will describe each in turn.
What the day of the injection looks like
The visit begins with a short check, not with the needle. The doctor makes sure the patient has not reached for opioids recently, has no withdrawal symptoms, no jaundice and no planned operation that would need painkillers from that group. In parallel the preparation is made ready, because once taken out of the fridge it has to come up to room temperature. The injection is deep and intramuscular, into the buttock, with a needle matched to the body build, so that the medicine reaches the muscle and not the skin. Successive doses are given alternately, once in one buttock, once in the other.
How many weeks one naltrexone injection works
A single dose releases over about 4 weeks, which is why the next administrations are planned roughly every month. Towards the end of the cycle the medicine's effect weakens, an added reason not to be late with the next dose. If the date is missed, the next injection is given as soon as possible, but no sooner than 4 weeks after the previous one.
How long the whole treatment lasts
The honest answer is: it depends. The product information sets neither a lower nor an upper limit on the length of therapy, and scientific societies most often speak of a period of no less than six months. The duration is decided by the course, that is, whether the patient keeps abstinence and how they tolerate the successive doses. Numbers from studies are worth reading with care. In Garbutt's randomised trial, published in JAMA in 2005, the 380 mg dose was linked to about a 25% stronger drop in the number of heavy drinking days compared with placebo. A meta-analysis of seven studies from 2022 additionally suggested that longer treatment, beyond three months, gives a clearer effect, but the authors themselves admit that the material covered therapy of at most six months. This points to a direction, not a promise, because naltrexone works best paired with therapy.
Lodz realities: alcohol availability and the place of the injection
Lodz has for years grappled with easy access to alcohol, and that is one of the factors that make keeping abstinence harder. Against this backdrop you can see why a patient needs an extra tool, such as pharmacotherapy.
How many alcohol outlets Lodz has
The City Council set a maximum of 5400 alcohol sales permits for the city, of which 3600 go to catering and 1800 to shops. The number of outlets actually operating is lower: in spring 2025 there were over 1160 of them, yet back in 2023 the city counted more than 1700 points of sale, that is one for every 385 residents. The scale of this availability pushed the city towards restrictions, and since 17 October 2025 a night-time ban on alcohol sales in shops, between 22:00 and 6:00, has been in force in seven inner-city districts.
What the data from the Lodz sobering-up station says
The scale of the problem is also visible from the sobering-up station, which operates at the Municipal Centre for Therapy and Health Prevention on Przybyszewskiego street. In 2023 close to 8 thousand people passed through it, and in the following years that number kept rising. Behind every such intervention stands a specific person, often someone who has already tried to quit drinking and is looking for support more effective than willpower alone. For some of these people the naltrexone injection turns out to be exactly the missing piece.
How to book qualification for the injection in Lodz
The first step is a phone call to 880 808 880 and booking a qualification at our clinic on Rogozińskiego street. The injection is rarely the whole answer, which is why from the start we propose it together with addiction therapy in Lodz, and when the situation calls for it, also with full alcoholism treatment in Lodz. We only talk about the price after the visit, and not out of contrariness, but because it is made up of several separate items: the consultation, the tests, bringing in the medicine and the administration. Until we know the patient's situation, any figure given upfront would be guesswork.
Three pharmacotherapy methods: injection, implant or tablets, and who they suit
Since the choice of method is made at qualification anyway, it helps to know what we are choosing between. In the pharmacological treatment of alcoholism three different approaches meet, and each suits someone different.
- The naltrexone injection dampens the pleasure from alcohol and the craving, and a single administration lasts about a month.
- The disulfiram implant works through fear of a sharp reaction after drinking, and it is replaced every few months.
- Naltrexone tablets contain the same medicine as the injection, only they are swallowed every day.
Naltrexone injection versus the disulfiram implant
The difference is easiest to see by looking at how each of these medicines treats a drink. Disulfiram punishes, because after alcohol it provokes violent, dangerous symptoms, so the patient does not drink out of fear. Naltrexone does not react to a glass at all; it simply takes the reward out of drinking and, over time, quiets the craving. The logistics differ too. The disulfiram implant has to be placed surgically and renewed roughly every eight months, whereas the naltrexone injection is a shot every 4 weeks, with no incision. Anyone leaning towards the aversive option will find the details on the page about the alcohol implant in Lodz.
The injection versus naltrexone in tablets
Here the substance is the same; only the way of taking it differs. The tablet is cheap and fully registered in Poland, so we can get it on the spot, without import. The catch is that its effectiveness depends on daily regularity, and it is precisely on a weaker day that a dose is easiest to skip. The injection removes this temptation, because once given it works for the whole month, regardless of mood. The depot form, however, cannot be bought off the pharmacy shelf; it has to be brought in through targeted import.
Who helps choose the method
There is no method that is good for everyone. The choice depends on the drinking history, coexisting illnesses, medicines being taken and what matters most to the patient. Someone who is uneasy at the thought of a surgical procedure will look at the injection differently from a person seeking one strong stimulus. That is exactly why the method is decided by the doctor together with the patient during qualification, and not by the patient alone on the basis of an advert.
