Naltrexone is a medication for treating alcohol and opioid addiction. Naltrexone can help you stop drinking alcohol by easing alcohol cravings and withdrawal symptoms when you quit alcohol. Naltrexone is usually taken as a daily pill or administered as a once-a-month injectable. It’s not addictive, and it usually only causes mild and short-lasting side effects.
Naltrexone can only be taken by people who have already stopped using alcohol or opioids for over a week. It cannot be used to treat withdrawal symptoms and needs to be taken continuously to reduce opioid or alcohol cravings.
Created by Endo Laboratories in 1963, naltrexone was first developed to treat opioid addiction. It was approved by the FDA for this purpose in 1984.
During the 1980s, naltrexone showed promise in animal testing for its potential in treating alcohol dependency. This promise was then proven in human clinical trials. These clinical trials confirmed that, when combined with therapy, naltrexone reduced alcohol cravings and relapse rates. And naltrexone and alcohol became a common pair.
How Is Naltrexone Taken?
Naltrexone is offered under the brand names ReVia and Depade (in pill form) and Vivitrol (long-acting injected naltrexone). As a pill, naltrexone is usually taken at a dose of 25 mg to 50 mg daily. As an intramuscular injectable in its extended-release formula, naltrexone is usually administered once a month, at a dose of 380 mg. Some people prefer Vivitrol since you don’t need to remember to take a pill regularly like with ReVia or Depade.
Naltrexone works by reducing cravings for alcohol and opioids. It does this by binding and blocking opioid receptors in your body. It works differently than commonly prescribed buprenorphine and methadone treatments, which trigger your brain’s opioid receptors to reduce cravings.
Naltrexone prevents the blissful and calming effects of opioids. For naltrexone and alcohol, it is thought to block the pleasurable feelings associated with alcohol use and reduce alcohol cravings.
Opioid drugs like heroin bind to opioid receptors in your body and mimic the effects of these chemicals, which naturally help kill pain. Their effects can also make you feel euphoric. Ethanol is the main ingredient in alcohol, and it also impacts opioid receptors, though researchers are still learning how.
In any form (ReVia, Depade, or Vivitrol), naltrexone works by affecting your reward system. Your brain contains opioid receptors. These receptor sites naturally produce neurotransmitters. Neurotransmitters are chemical messengers that release painkilling chemicals.
As an opioid antagonist, naltrexone works by blocking opioid receptors. This limits the effect opioid drugs can have and may reduce opioid cravings. As a result, it is very effective for treating opioid addiction.
For naltrexone and alcohol, the way naltrexone works is still being researched. It is thought to help because of the way it works on the reward system and the neurotransmitter dopamine.
In animal testing research, the opioid agonist (morphine) was shown to increase alcohol consumption, while opioid antagonists (like naltrexone) decreased alcohol consumption. This suggests that the opioid reward system is involved in some way with the enjoyable or “rewarding” aspects of alcohol consumption.
Most researchers agree that the link between alcohol consumption and the opioid system is most likely due to the neurotransmitter dopamine, which plays a large role in the brain’s reward and motivation system. A meta-analysis of 19 studies found that, when compared to a placebo, naltrexone significantly reduced relapse rates of those in short-term treatment for alcohol use disorder.
Naltrexone is not used to treat the immediate withdrawal symptoms associated with opioid or alcohol use disorder. Instead, it’s used to manage opioid and alcohol cravings and addiction. Naltrexone can help people who have already quit alcohol or opioids remain free from drugs and alcohol.
Most potential side effects of naltrexone are mild and don’t last long, although some people’s systems may be more sensitive to their effects. e Common side effects of naltrexone include:
- Upset stomach
- Anxiety and nervousness
- Muscle pain
- Joint pain
More serious side effects of naltrexone are rare, but may include:
- Tiredness or drowsiness
- Stomach pain, nausea and vomiting, or diarrhea
- Rash on skin
- Vision problems (blurriness)
When taken in higher doses (higher than prescribed clinically), naltrexone can cause liver failure and other serious problems. Stop taking naltrexone and seek medical care if you experience any of these:
- Unusual bruising or bleeding
- Extreme loss of appetite
- Yellowing of the skin or eyes
- Dark urine
- Upper abdominal pain
NALTREXONE AND ALCOHOL: CAN I TAKE IT WHILE I’M DRINKING?
It is not recommended to drink alcohol while on naltrexone, but it does not produce any immediate harmful effects. It will prevent the feeling of being drunk, so most people who abuse alcohol don’t see the point of mixing alcohol and naltrexone. This doesn’t mean that you are not impaired if you drink while on naltrexone. It is still unsafe to drive and operate heavy machinery.
Treatment with naltrexone is considered non-addictive and non-habit-forming.
Although ReVia, Depade, and Vivitrol are considered safe and effective drugs for treating opioid use disorder and alcohol use disorder, there are some risks of taking naltrexone:
- Naltrexone is prescribed only after you have stopped using opioids or alcohol for at least 7 to 10 days. If it’s taken along with drugs of abuse or alcohol, it can cause severe withdrawal symptoms.
- You must get through the initial withdrawal process before beginning to manage cravings with naltrexone. The initial withdrawal symptoms are usually the hardest to overcome during recovery.
- Individuals with acute liver problems, kidney problems, or hepatitis should not take naltrexone as it could worsen these conditions.
- Although naltrexone has shown promise as a safe opioid treatment for pregnant women, there is not enough research in this area yet. Pregnant women should not take naltrexone without approval from their doctors.
- Because naltrexone blocks some of the effects of alcohol and opioids, individuals who have used naltrexone and then return to drinking or using opioid drugs may be more sensitive to the effects of drugs or alcohol, or not feel the full effects of the amount they’ve used. This can lead to overdose or dangerous behavior.
- For naltrexone to successfully manage addiction, you must continue to take the medication. A missed dose could lead to an increase in cravings or to relapse. Vivitrol is sometimes preferred to avoid forgetting to take a pill. It is a monthly shot in a doctor’s office.
- Naltrexone should never be used with high doses of opioid drugs. This can result in coma or death.
- Before starting naltrexone, you should discuss all your medications and any possible interactions with naltrexone with your doctor. Medications of potential concern include cough medications, disulfiram, or thioridazine. Naltrexone may affect your thoughts and reaction time. Know how you react to naltrexone before driving or performing any activity that requires you to be alert.
Research suggests naltrexone is an effective tool for helping people with alcohol use disorders or opioid use disorders control and reduce drug and alcohol cravings. But substance use disorders are complex and require holistic addiction treatment that helps you sustain recovery.
Naltrexone is not a cure-all for addiction. Because naltrexone cannot be taken during withdrawal, you must get through what is perhaps the most physically and psychologically taxing part of recovery before you can start taking it. Once you have gotten through withdrawal, your doctor may prescribe ReVia or Vivitrol to help control cravings and lingering withdrawal symptoms. Naltrexone is not a long-term solution for alcohol addiction recovery, and it’s typically only prescribed for up to three months.
With less alcohol cravings, you’re better able to focus on the addiction treatment you need that addresses the reasons why you abuse alcohol. Professional addiction treatment starts with alcohol detox and is followed by inpatient rehab or an outpatient treatment program. Treatment programs typically include:
- Behavioral therapy
- Support groups
- Treatment from addiction experts
- Addiction and mental health education
- Medication management as appropriate
Support is critical during withdrawal and early recovery. You’ll reduce your chances of relapse or dangerous withdrawal symptoms if you enter a medical alcohol detox program that offers 24/7 supervision and psychological support. You may be given other medications during detox, including other forms of MAT (medication assisted treatment) or medications that treat individual withdrawal symptoms, such as medications to combat insomnia or nausea.
In this type of program, you’ll also receive psychological support around the clock. This helps you process what you’re going through and restricts your access to substances that could lead to relapse. Detoxing at home cold turkey is likely to lead to relapse because of uncomfortable withdrawal symptoms and triggers.
If you return to alcohol after a period of abstinence, your tolerance may be lower. Taking the same dose or drinking the same amount you were accustomed to before could more quickly result in overdose.
Alcohol Addiction Treatment
In an alcohol treatment program, you’ll address the underlying reasons behind why you drink. If you can work on these underlying issues, you may be less likely to numb feelings with alcohol. Some common underlying issues of addiction include:
- PTSD and trauma
- Co-occurring mental health disorders
- Unhealthy early relationships with family or caregivers
- Lack of self-esteem and low stress tolerance
- Grief and loss
The two types of alcohol addiction treatment are residential treatment and outpatient treatment. There are different types of outpatient treatment, ranging from partial hospitalization programs that meet for several hours each day to groups that meet a few hours a week.
A structured addiction treatment program like Footprints to Recovery typically includes types of therapy and approaches like:
- Individual and group therapy
- Family therapy
- Support groups like Alcoholic Anonymous or SMART Recovery
- Psychiatry appointments if medication is needed for a dual diagnosis (co-occurring mental health disorder)
- Holistic approaches like yoga, art therapy, music therapy, nutrition, psychodrama, and other experiential activities
- Trauma therapies like EMDR
- Aftercare planning and alumni program
Specific treatment depends on the treatment center and your treatment plan.
Naltrexone is not right for everyone. Only a physician and psychiatrist can determine if naltrexone is clinically appropriate for you. Reasons why people are prescribed naltrexone include:
- They are chronic alcohol abusers.
- They relapse on alcohol frequently.
- They relapse on alcohol in early recovery.
- They experience intense alcohol withdrawal symptoms.
Naltrexone isn’t t a fast fix for addiction, but it can play an important role in recovery for some people, particularly those in a comprehensive treatment program with long-term plans for recovery. For most people with a substance use disorders, withdrawal is just the first step on a long journey. You need tools and skills to succeed in recovery and beyond. Naltrexone is a small part of that journey.
Along with therapy, where you learn invaluable coping and life skills, medication assisted treatment (MAT) can help make everyday life more manageable and reduce the risk of relapse. Naltrexone may be an ideal choice for some patients with alcohol dependence issues because it isn’t habit-forming and usually has mild side effects. It should be used as part of a comprehensive treatment program.
Looking for Alcohol Addiction Treatment?
Withdrawal from alcohol can be extremely uncomfortable, dangerous, and even life-threatening. Undergoing withdrawal in a professional recovery center ensures a safe and successful withdrawal. Footprints to Recovery treatment facility offers medical detox followed by comprehensive inpatient treatment and outpatient treatment options. Our alcohol addiction treatment is effective because it is evidence-based and includes individualized treatment plans. We can help determine whether naltrexone and alcohol treatment is right for you. Call us for a free, confidential consultation.