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Opioid antagonists vs. agonists: A battle to fight addiction Maybe it's that cigarette when you're having a drink with friends or that piece of chocolate you must have after lunch. Cravings come in all forms. While a far cry from the addictive nature of opioids, many can get a sense of what seems like an uncontrollable need for a fix. Alleviation of cravings is a key element setting one opioid abuse treatment apart from the others. While the need for treatments becomes more urgent as the opioid epidemic grows, stigma about addiction has made it a hard space to crack, with few pharmaceutical companies interested. Alkermes plc's addiction treatment Vivitrol (naltrexone) is one of the few exceptions, standing out as an alternative to traditional means of treating addiction like methodone, which is habit-forming itself. Elsewhere, the mounting numbers of overdoses encountered by first responders have boosted use of the reversal agent naloxone. More than 23 million Americans are addicted to drugs and alcohol, and the economic impact on the healthcare system totals $700 billion annually, according to a recent report from trade group BIO . In 2016, over 42,000 Americans died from an opioid overdose, data from the Centers for Disease Control and Prevention show. Forty percent of those deaths involved a prescription opioid. Despite the enormous societal cost, the report notes only 29 compounds in the pipeline for addiction treatment — 18 for substance abuse, five for alcohol addiction and three for smoking cessation. In oncology, by comparison, more than 2,600 programs are underway. There are just four Food and Drug Administration-approved treatments on the market for addiction treatment, with another OK'd for use as an emergency reversal agent. Vivitrol, an opioid antagonist, is one of the most well known. The drug works by blocking the uptake of endorphins to opioid receptors in the brain, thus limiting the ability to get high. First approved in 2006 for alcohol dependence, Vivitrol's label was expanded in October 2010 to include prevention of relapse from opioid abuse after detoxification.

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