What is Naltrexone? How It Works for Alcohol Use Disorder

Alcohol Use Disorder (AUD) remains a significant public health challenge, impacting millions and contributing to approximately 178,000 deaths annually in the U.S. alone.

Despite the gravity of the situation, treatments are available that can offer hope and recovery. Among these, Naltrexone stands out as a powerful yet underutilized option.

Approved by the FDA over three decades ago, Naltrexone is a prescription medication used in the treatment of AUD. It works by blocking the euphoric effects and feelings of intoxication, helping individuals reduce their alcohol consumption and maintain sobriety.

However, before beginning this medication, it is important to understand how it works and what you can expect when taking it.

In this blog post, we'll explore what Naltrexone is, how it works, and its effectiveness in treating AUD.

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What is Naltrexone?

Naltrexone is a prescription drug used in medication-assisted treatment. It acts as an opioid antagonist, and it is FDA-approved for treating alcohol use disorder and opioid use disorder.

The prescribed naltrexone dosage can vary per person, but generally,  the tablet form of naltrexone, marketed under brand names ReVia and Depade, is typically prescribed at a dosage of 50 mg daily. Alternatively, Vivitrol, an injectable extended-release version of naltrexone, is administered as a 380 mg intramuscular injection once a month.

Since naltrexone is an opioid antagonist, it blocks the euphoric effects that occur when someone misuses substances. Naltrexone can also help a person to stay in recovery and lower their risk of relapse.

Since Naltrexone is a regulated drug, it must be prescribed by a licensed healthcare provider only.

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Naltrexone Ingredients

Ingredients in the tablet form include lactose monohydrate, hypromellose, magnesium stearate, polyethylene glycol, colloidal silicon dioxide, hydroxypropyl cellulose, yellow ferric oxide, and red ferric oxide. 

Numerous generic tablet versions of naltrexone have various inactive components. To see the full list of inactive components, look at the label of the product you're using.

Types of Naltrexone 

Naltrexone is available in several forms, described below. 

Injectable Naltrexone

Naltrexone is available in an injectable form that is delivered into the muscles. The form of naltrexone is long-lasting and is given once per month. 

It is approved for treating both opioid use disorder and alcohol use disorder. Injectable naltrexone is available under the brand name Vivitrol.

Oral Naltrexone 

The oral version of naltrexone is a pill that is generally taken once per day. Some patients take a larger dose of oral naltrexone every other day, or in some cases, every three days. 

Talk with your doctor about the best dosing schedule for your needs. The oral form of naltrexone is marketed under the brand name ReVia. 

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How Naltrexone Works

Over time, naltrexone can reduce the association of alcohol and pleasure in your brain. This changes the brain’s reward pathways so that you can moderate or stop drinking altogether.

If you’ve had pleasurable experiences drinking alcohol in the past, your brain can associate those pleasurable experiences with alcohol. Similar associations occur when eating food or having sex. 

It motivates us to continue these behaviors for survival. The same area of the brain responsible for associating pleasure with these activities is responsible for forming habits. Repeated activation of this region of the brain through alcohol creates a “positive reinforcement,” which results in the brain forming an intense desire, or craving, for these substances.

Naltrexone blocks the receptors in your brain that trigger the pleasurable feeling that drinking brings. You’ll still feel the effects of alcohol such as bad coordination and judgment, but you won’t experience the “buzz.” 

It reduces the desire to keep drinking. For many people, this translates into having fewer drinks and subsequently drinking less overall. Over time, the desire to drink and cravings for alcohol can be eliminated.

Naltrexone has been shown to be effective by many studies, but it’s not a magic pill and it doesn’t work for everyone. Medication adherence, or taking the medications as prescribed, is extremely important for naltrexone to work as intended. 

Even missing a single dose by accident or feeling the effects of alcohol can make it less effective. Confidant providers and recovery coaches can help you develop strategies to stick to your naltrexone plan. This can sometimes involve support from a loved one.

Read More: When is the Best Time to Take Naltrexone?

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Why Choose Naltrexone for Alcohol Use Disorder

Other medications can help you cut back on alcohol consumption, but naltrexone has been effective and has a good safety record. Some of its advantages are as follows:

Effective

Naltrexone has been studied to help reduce alcohol consumption in 30+ clinical trials over a 20 year period and has consistently shown positive results, especially in reducing the amount of drinking.

Proven Safety Profile

Naltrexone has been prescribed for over 30 years and has been effective for a wide range of people. Side effects from naltrexone are rare.

Accessible

You can use naltrexone as needed to reduce your drinking. Naltrexone is also safe for use by people with or without other conditions such as hypertension, type 2 diabetes, or dyslipidemia.

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Who Benefits from Naltrexone Treatment?

You don’t need to have a medical condition or an addiction to want to change your relationship with alcohol. Naltrexone can help you moderate or quit drinking. While naltrexone does not work for everyone, it is shown to be effective in reducing drinking for most people.

The effectiveness of naltrexone can decrease when it is not taken as prescribed. Confidant providers and coaches can help you develop a plan to stick to your plan with naltrexone.

Naltrexone can be taken in combination with some of the other medications for alcohol use disorder but cannot be taken in combination with the other medications for opioid use disorder (methadone and buprenorphine) or with prescription pain medications or illicit opioids. Taking naltrexone with opioids can cause sudden and severe withdrawal symptoms.

Naltrexone is not recommended for use in pregnancy.  Naltrexone should not be used if you have a serious liver condition as the drug is metabolized in the liver.

To make sure naltrexone is right for you, you should disclose all important medical information to your Confidant provider. Initial prescription, as well as dosage adjustments should be monitored for side effects and potential effects on pre-existing conditions.

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Naltrexone Side Effects and Risks

Some people may feel “weird” when taking naltrexone, because of the side effects associated with this medication. Common naltrexone side effects are as follows:

• Headache
• Dizziness
• Sleepiness
• Nausea and vomiting
• Reduced appetite
• Muscle and joint pain
• Toothache
• Sleep disturbance
• Cold symptoms
• Overdose

It's also important to note that naltrexone should not be taken by individuals currently using opioids, as it can precipitate withdrawal symptoms. Because of these risks, it's crucial for patients to be under the care of a healthcare provider who can monitor their response to the medication and make adjustments as necessary.

Always discuss your medical history and current health conditions with your doctor before starting naltrexone to ensure it's safe for you.

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What to Avoid When Taking Naltrexone

Naltrexone cannot be taken in combination with other medications for opioid use disorder (methadone and buprenorphine) or with prescription pain medications or illicit opioids. Taking naltrexone with opioids can cause sudden and severe withdrawal symptoms.  

It should not be used if you have a serious liver condition as the drug is metabolized in the liver. You should not also take narcotics to fight the effects of naltrexone as it can lead to coma or death.

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Is Naltrexone an Opioid?

Naltrexone is an opioid antagonist. This means it works by blocking the opioid receptors in the brain. Naltrexone does not cause dependence and is not habit-forming.

When you drink, your body produces endorphins. These endorphins are actually endogenous opiates (a scientific way of saying opioids are created by your body). For many people, the release of these endorphins and the pleasurable feeling they trigger translates into a desire to keep drinking.

Unfortunately, this endorphin system is not very sophisticated. Your biological functions can’t tell if you have a big meeting tomorrow or an important test coming up that week. As a result, it feels good just to keep drinking regardless of the negative consequences.

When you take naltrexone, it blocks the opioid receptors that are activated by the endorphins and prevents the pleasurable sensation. This means your brain will no longer be rewarded for consuming alcohol. Over time, this can result in pharmacological extinction - meaning your brain loses interest in and no longer craves alcohol.

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Naltrexone FAQs

Is naltrexone considered a narcotic?

No, naltrexone is not a narcotic. To put it simply, it prevents you from experiencing the "high" that you get from using substances. One possible side effect is that it prevents you from experiencing the "high" that alcohol may provide. There won't be any intoxicating side effects or physical or mental dependence.

What is naltrexone for?

Naltrexone is beneficial for those who are diagnosed with alcohol or opioid use disorder.

How can I get naltrexone?

Naltrexone cannot be purchased without a doctor's prescription. Seek help from the experts if you need this certain medical treatment.

Is naltrexone a controlled substance?

The prescription medicine naltrexone is not on the list of banned substances since it is used to treat alcoholism and opiate use disorders.

How long do naltrexone side effects last?

The minimal negative effects of naltrexone often disappear within a few days of treatment. The longest time for side effects to last is two weeks.

How long does it take for naltrexone to work?

Naltrexone will begin to work soon after taking your first dose. This is because the medication blocks opioid receptors in the body. Once it takes action and blocks these receptors, the euphoric effects of alcohol are reduced.

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Overcome Alcohol Use Disorder with Confidant Health

Taking naltrexone for alcohol use disorder can reduce your cravings and make it easier for you to stay in recovery. If you’re ready to begin treatment for alcohol misuse, you may be concerned about taking time off from work or traveling to an office to meet with a doctor. 

The good news is that Confidant Health offers online medication-assisted treatment, which means you can consult with a doctor without leaving your home or office. This convenience ensures that getting the help you need is both private and easily accessible, making the path to recovery smoother and more manageable.

Book an appointment today with Confidant Health to start your journey toward recovery.