All About Naltrexone

Opioid and alcohol misuse is still a significant public health issue in the United States and worldwide. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 14.5 million individuals ages 12 and older suffered from alcohol use disorder (AUD) and nearly 50,000 people in the United States died from opioid-involved overdoses in 2019. 

This national crisis affects not only public health but also social and economic welfare. According to the Centers for Disease Control and Prevention (CDC), the overall “economic burden” of prescription opioid misuse in the United States is estimated at $78.5 billion a year, and heavy drinking at around $249 billion each year. This cost includes hospital expenses, lost income, addiction recovery, and criminal justice involvement. 

Due to the growing concern, naltrexone was approved by the U.S. Food and Drug Administration (FDA) to treat people with alcohol use disorder (AUD) and opioid use disorder (OUD). Naltrexone is marketed under the brand names of ReVia and Vivitrol, among others. Naltrexone is a medication that helps people control their cravings and feelings of euphoria associated with substance use disorder. When used in combination with psychosocial therapy, naltrexone is a highly effective medication.

What Is Naltrexone Used for and How Does It Work?

Naltrexone is used as a pill or as an extended-release intramuscular injectable when treating both alcoholism and opioid addiction. The pill form (ReVia and Depade) is prescribed daily, and the extended-release injectable (Vivitrol) is administered once a month by a healthcare practitioner licensed for dispensing medications.

Naltrexone helps reduce the risk of relapses and is one of the most commonly used medications in treating alcohol use disorder and opioid dependence. 

Naltrexone is an opioid antagonist (inhibitor) that decreases cravings by blocking the euphoric and sedative effects of alcohol and opioids such as heroin, morphine, and codeine by binding to the endorphin receptors in the body and blocking opioid receptors in the brain. This function helps maintain abstinence and prolong recovery. Naltrexone has been shown to be effective in addiction maintenance treatment, is non-addictive and has low-risk potential for misuse. 

Patients should wait at least seven days after their last use of short-acting opioids and 10-14 days after their last use of long-acting opioids before beginning naltrexone treatment to minimize the risk of opioid withdrawal symptoms. However, naltrexone can be prescribed to people who are actively consuming alcohol. Decrease in opioid cravings may take several weeks after beginning naltrexone.

Ideal Candidates for Naltrexone Therapy

Naltrexone might not be an ideal treatment option for everyone with OUD or alcoholism. The medication is recommended for people who are: 

• Aged 18 years and older.
• Have no existing liver conditions, kidney problems, or bleeding problems such as hemophilia.
• Have no allergic reactions to naltrexone. 
• Have not been receiving opioid analgesics for health conditions.

Side Effects of Naltrexone Use

Every medication has its own range of side effects, some of which are more severe than others. If you encounter any during naltrexone maintenance treatment, don’t stop taking it without first consulting your doctor.

If you experience too many naltrexone side effects, your doctor can reduce your dose or replace it with another medication to treat opioid or alcohol addiction. The majority of naltrexone’s side effects will, however, fade over time. The following are naltrexone’s most common side effects:

• Nausea
• Sleepiness
• Headache
• Painful joints
• Muscle cramps
• Dizziness
• Vomiting
• Abdominal pain
• Decreased appetite
• Flu-like symptoms
• Insomnia
• Toothache

Naltrexone can cause adverse effects in rare circumstances. Severe side effects of naltrexone may include:

• Risk of opioid overdose during a relapse due to decrease in opioid tolerance
• Severe reactions at the site of injection
• Risk of liver damage or hepatitis
• Depressed mood
• Pneumonia
• Serious allergic reactions (skin rash, swelling, trouble breathing, etc.)

If you experience any of the following symptoms, contact your physician immediately.

Medical experts recommend that you talk to your doctor before starting naltrexone maintenance treatment about the following conditions to lower your chances of side effects:

• If you are pregnant, planning to become pregnant, or breastfeeding. 
• About all medications you are currently taking, prescriptions and non-prescription medicines, herbal supplements, and vitamins.
• Medical health conditions such as liver damage, hemophilia or other bleeding problems, kidney problems, and liver disease. 
• Allergic to naltrexone, including any of the ingredients or the liquid used to mix the extended-release naltrexone.
• Presently using any other form of illicit drugs.

Considering your medical conditions, your doctor can determine the safest dose of naltrexone or alternative medication.

Can You Overdose on Naltrexone Medication?

It is technically possible to overdose while taking naltrexone. This can happen if someone took large doses of opioids or alcohol in an attempt to counteract the effects of naltrexone.

If you miss a dose of naltrexone, it’s critical to take it as soon as possible. But if you’re too close to your next dose, then it’s best to skip the missed dose.  Avoid double dosing and take the next dose at your regular time. 

Missing naltrexone doses will reduce results and raise the risk of relapse. So make sure to follow the guidelines provided by your physician. 

Other Medications to Avoid During Naltrexone Treatment

Naltrexone has the potential to interfere with other medications, resulting in dangerous side effects. Since the medication is used for the treatment of alcohol and opioid addiction, certain medications must be avoided to prevent any sudden withdrawal symptoms. To prevent potential risks, consult your healthcare provider about any other medicines you’re taking, including over-the-counter drugs and herbal remedies, before starting naltrexone. The following medications can interact negatively with naltrexone:

• Narcotic drugs, such as codeine and hydrocodone
• Diarrhea medications
• Disulfiram
• Cough medication

Naltrexone isn’t a cure for opioid or alcohol addiction. It simply aids in maintaining sobriety while helping individuals in recovery concentrate on other aspects of care. According to clinical trials, some of the most important advantages of using naltrexone are its considerably low risk of causing adverse effects and risk-free potential misuse, physical dependence, and addiction. And unlike many other medications, it does not cause withdrawals during cessation.

If you are seeking help with your loved one’s addiction, contact us today or complete our quick contact form below, to speak with an addiction treatment specialist.

If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas, and Washington.