"U.S. prisons are experimenting with a highpriced monthly injection that could help addicted inmates https stay off opioids after they are released but skeptics question its effectiveness and say the manufacturer has aggressively marketed an unproven drug to corrections officials. A single shot of Vivitrol given in the buttocks lasts for four weeks and eliminates the need for the daily doses common with alternatives such as methadone. But each shot costs as much as  and because the drug has a limited track record experts do not agree on how well it works. Proponents say Vivitrol could save money compared with the cost of locking up a drug offender  about  a year for each inmate at the Sheridan Correctional Center  miles southwest of Chicago. Dr. Joshua Lee of New York Universitys medical school said more evidence is needed to determine whether the medication can help substantial numbers of people and whether its worth paying for but the early results are encouraging. It sounds good and for some of us it feels like the right thing to do said Lee a leading researcher on the treatment. Vivitrol is emerging as the nation searches for ways to ease an opioid epidemic https that affects more than  million Americans and an estimated  percent of the U.S. prison population. Many experts view prisons  where addictions human toll can be seen most clearly  as a natural place to discover what works. Christopher Wolf had already served prison time for nonviolent crimes when he was ordered into treatment for a heroin addiction by a judge who suggested Vivitrol. Three months later the yearold from Centerville Ohio is clean and working full time as a cook. He now suggests the medication to other addicts https I dont have cravings Wolf said. I see how much better life is. It gets better really fast. Vivitrol targets receptors in the brains reward system blocking the high and extinguishing urges. In some programs prisoners get an injection before release then followup shots from any clinic. For decades researchers have recognized addiction as a relapsing brain disease with medication an important part of therapy. But most jails and prisons reject methadone and buprenorphine the other governmentapproved medications for opioid addiction because they are habitforming and can be abused. Just ask Joshua Meador  an inmate at Sheridan who hopes to get into the Vivitrol program before his release in January. Before incarceration he abused both older treatment drugs. When given takehome doses of methadone for the weekend he would sell them for heroin. When Im on Vivitrol I cant get high he said. The drug has no street value or abuse potential. You couldnt design something better for the criminal justice system said David Farabee of the University of California at Los Angeles who leads a Vivitrol https study in a New Mexico jail. Theres been pushback with other medications people saying Were just changing one drug for another. That argument goes out the window when youre talking about a blocker like Vivitrol. Prison systems in Illinois Vermont Wyoming and Wisconsin are trying the drug on a small scale. Michigan is offering Vivitrol to parolees who commit small crimes if addiction is the reason for their new offense. The federal Bureau of Prisons ran a field trial in Texas and plans to expand the program to the Northeast next year. The drugs manufacturer hopes prisons will be the gateway to a larger market. Also known as extendedrelease naltrexone the medication won Food and Drug Administration approval for alcohol dependence in  and in  to prevent relapse in postdetox opioid users. The evidence for giving Vivitrol to inmates is thin but promising. In the biggest study sponsored by the National Institute on Drug Abuse about  offenders  most of them heroin users on probation or parole  were randomly assigned to receive either Vivitrol or brief counseling and referral to a treatment program. After six months the Vivitrol group had a lower rate of relapse  percent compared with  percent. A year after treatment stopped there had been no overdoses in the Vivitrol group and seven overdoses including three deaths in the other group. The results published in March in the New England Journal of Medicine have been promoted by the drugmaker Irelandbased Alkermes as it markets Vivitrol to U.S. correctional systems. Yet addiction is stubborn. When the injections stopped many in the study relapsed. A year later relapse rates looked the same in the two groups. It does suggest six months wasnt enough said Lee the lead author. T.J. Voller was a Vivitrol success story  until he wasnt. After Vivitrol was approved by the FDA Voller talked about getting the shot with The Associated Press and Dr. Sanjay Gupta in a CNN segment. The yearold was back at work and seemed proud of his recovery. But after  months on Vivitrol he died of a heroin overdose https He was alone for the weekend and picked up that needle one last time said his mother Kathi Voller of Raynham Massachusetts. Advocates argue that inmates have a constitutional right to all FDAapproved addiction medications throughout their incarceration. Treatment should be offered from the moment they are brought into the system said Sally Friedman legal director of the New Yorkbased Legal Action Center which is looking for a test case to bring to court. Physicians have learned to be cautious about pharmaceutical company marketing said Andrew Kolodny senior scientist at the Heller School for Social Policy and Management at Brandeis University. Not so for criminal justice officials who may be too trusting Kolodny said. When the drug company sends someone in to give them a talk and buy them pizza they think theyre getting a scientific lecture he said. Alkermes spokeswoman Jennifer Snyder said the companys sales team helps educate corrections staff and community care providers only after they have shown interest in Vivitrol. Theres widespread agreement that counseling support groups and treatment for underlying problems such as depression are crucial for Vivitrol patients said Dr. Joseph Garbely of Pennsylvaniabased Caron Treatment Centers which supports medicationassisted treatment and prefers Vivitrol. The disease of addiction is a cunning baffling and powerful one Garbely said. And you need all hands on deck."