Naltrexone for Alcohol Use Disorder: The Benefits and Risks

Naltrexone is a prescription medication used in the treatment of both opioid and alcohol use disorders. Naltrexone alcohol treatment can reduce your cravings and help you to stay in recovery. Before beginning this medication, it is important to understand how it works and what you can expect when taking it. Below, we explain everything you need to know about taking naltrexone for alcohol misuse. If you have additional questions, consult with a doctor who provides medication assisted treatment for alcohol use.

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. Since naltrexone is an opioid antagonist, it blocks the euphoric effects that occur when someone misuses substances. 

Another benefit of taking naltrexone for alcohol use disorder is that the medication can suppress alcohol cravings and reduce the amount that someone drinks. Once a person has decided to stop drinking, naltrexone can help them to stay in recovery and lower their risk of relapse. 

Research has shown that some people have genetic risk factors that lead to stronger alcohol cravings and increased feelings of euphoria when drinking. For people with these genetic risk factors, naltrexone may be especially effective for preventing relapse. 

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. This 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 of 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. 

Naltrexone For Alcohol Misuse: How It Works

Taking naltrexone to stop drinking has been proven to be effective. Clinical trials conducted to determine the safety and effectiveness of the medication have shown that naltrexone for alcohol use disorder reduces the number of drinking days, lowers relapse rates, and treats alcohol cravings. While taking naltrexone, patients with alcohol use disorders often participate in counseling and other therapies to prevent relapse and learn strategies for coping without turning to drinking. 

Based upon the research with naltrexone, this medication is beneficial for those who are dependent upon alcohol. Naltrexone works for alcohol dependence by blocking the body’s opioid receptors. When these receptors are stimulated by alcohol or another substance, the result is a euphoric feeling.  Since naltrexone blocks these receptors, the pleasant feelings that occur with alcohol use are weakened, which lowers the drive to drink. 

While taking naltrexone for alcohol misuse can lower your cravings and relapse risk, this doesn’t mean that naltrexone is a “magic pill.” It is important to stay committed to taking your medication every day, if you’re on the oral form, and to participate in other services, such as individual and group counseling, to help you remain alcohol-free. 

Naltrexone Dosage for Alcohol

The naltrexone dosage for alcohol dependence will vary based upon the type of naltrexone you are taking. If you’re on an intramuscular naltrexone injection called Vivitrol, you will typically take 380 mg once per month. 

If you’re on oral naltrexone, the dosage is typically 50 mg once per day. Your doctor may opt to prescribe a 100 mg pill taken every other day, or a 150 mg pill taken every three days. 

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Naltrexone and Alcohol Misuse FAQs

If you’re taking naltrexone for alcohol use disorder, or you’re considering beginning this medication, the information below can also be useful. 

Does Naltrexone Work For Heavy Drinkers?

Naltrexone has been found to be effective for reducing drinking. In fact, a recent report that reviewed the results of 64 different studies found that naltrexone was more effective than acamprosate, another alcohol use disorder medication, for reducing heavy drinking and alcohol cravings. 

Does Naltrexone Work If You Don’t Drink?

The intention of a naltrexone regimen is to reduce drinking. If you are in treatment for an alcohol use disorder and have not been drinking, naltrexone can reduce alcohol cravings and make it easier for you to continue to abstain from alcohol consumption. 

How Long Does Naltrexone Take 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. 

How Does Naltrexone Make You Feel?

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

While you may feel sick or “weird” while taking naltrexone, side effects are usually mild, and they are outweighed by the benefits of this medication. In rare cases, patients may experience extreme side effects, such as liver damage, depressed mood, pain or swelling at the injection site, or allergic reaction. If side effects are severe or so bothersome that they interfere with daily life, talk with your doctor.

How Long Will I Take Naltrexone?

The length of time you spend on naltrexone will depend upon your individual needs and preferences. Your doctor can help you to determine how long you should take naltrexone for alcohol misuse. Some people may only take it for a short period, whereas others may take the medication for years.

Experts recommend that people stay in treatment for at least three months, so you may benefit from taking naltrexone for at least this amount of time to keep you engaged in recovery. Talk with your doctor about how long you should take naltrexone. 

When Is The Best Time To Take Naltrexone? 

If you are taking naltrexone by mouth each day, your doctor will tell you when to take your medication. Many patients benefit from taking naltrexone at the same time each morning, so they remember to take it.  You may benefit from setting a reminder on your phone so you do not forget your medication. 

What Is The Success Rate of Naltrexone? 

It is difficult to determine the overall success rate for naltrexone, because there are different definitions of success. In addition, success rates can vary based upon the length of time that patients are followed. For example, some studies may follow patients for just 6 months and evaluate relapse rates while taking naltrexone, whereas others may follow patients for a year or more.

A study with young adults found that over the course of a year, naltrexone was more successful than a placebo was for reducing heavy drinking. Among patients taking naltrexone, the amount of drinking reduced from 8 weeks to 6 months after naltrexone treatment, and then decreased again from 6 months to 12 months, which suggests that naltrexone is successful over the long term. 

How Long Does Naltrexone Block Alcohol?

So, how long does naltrexone block the euphoric effects of alcohol? It depends upon the type of naltrexone you take. Oral naltrexone has a half life of about 4 hours, meaning that half of the dose is removed from your body in this amount of time. For this reason, oral naltrexone is effective for about a day, which is why most patients take the medication daily.

On the other hand, injectable naltrexone is given once per month and has a half-life of 5 to 10 days. This means its effects will last much longer. By the end of the month, some of the effects of injectable naltrexone may be reduced, but a once-a-month injection has been found to be effective. 

What Happens If You Drink Alcohol While Taking Naltrexone?

If you drink alcohol while taking naltrexone, you will not feel any euphoric effects, since naltrexone is an opioid blocker. Some people believe that they will get sick if they drink while on naltrexone, but this is not the case. Antabuse, another medication used to treat alcohol use disorders, will cause patients to become extremely sick if they drink while on the medication, but Antabuse is different from naltrexone.

Does Naltrexone Help With Alcohol Withdrawal?

Naltrexone is not intended to treat alcohol withdrawal symptoms; instead, its intended use is to block the euphoric effects of alcohol to reduce cravings and discourage drinking. Before stopping drinking, it is important to consult with your doctor about the best course of treatment for alcohol withdrawal. 

In severe cases, alcohol withdrawal can lead to hallucinations, seizures, and a potentially fatal condition called delirium tremens.  Alcohol withdrawal is typically treated with a class of drugs called benzodiazepines, and some patients may need to be hospitalized while undergoing withdrawal.  You should not attempt to self-medicate withdrawal symptoms with naltrexone. 

Being Naltrexone Treatment With Confidant’s Online Doctors

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. 

Download the Confidant app today, on either the Apple Store or Google Play Store, and you can begin virtual medication assisted treatment for alcohol use.