Naltrexone for Alcohol

Alcohol use disorder (AUD) remains a major health concern in the U.S. and worldwide. The number of individuals with AUD has steadily increased throughout recent years, especially during the recent Covid-19 outbreak. According to the Centers for Disease Control and Prevention (CDC), about 13% of Americans admitted to starting or increasing substance use as a means to cope with the stress and isolation that was prevalent during the pandemic. 

The increase in the harmful use of alcohol has forced federal governments worldwide to reinforce various measures and policies to control alcohol consumption, including the regulations on marketing alcoholic beverages and their availability. However, the most significant of all is the steps taken to educate the public on AUD and address the stigma associated with addiction. And subsequently, pave the way for more people to seek treatment.

Treatment for AUD generally includes a combination of medications, evidence-based behavioral therapy, and counseling to help address both the physical and psychological components of addiction. There are currently three medications approved by the U.S. Food and Drug Administration (FDA) to help people achieve long-term sobriety by managing withdrawal symptoms and reducing the risk of relapse. One such approved medication for alcohol use disorder (MAUD) is naltrexone.

What Is Naltrexone?  

Naltrexone, sold under the brand names: Vivitrol, Depade, and ReVia, is a prescription medication used to treat alcohol use disorders and opioid use disorders (OUDs). Naltrexone is available as a pill (Depade and ReVia) and injectable (Vivitrol) and is developed to help reduce and suppress cravings for alcohol and opioids. Naltrexone is relatively pure and long-lasting and can be prescribed by any practitioner licensed to prescribe medications. 

Naltrexone is a non-addictive and non-narcotic medication with a low risk of misuse. However, since naltrexone tends to create serious withdrawal symptoms in individuals with opioids in their system, it can only be prescribed to people who haven’t taken opioids for 7-14 days before naltrexone treatment. This includes those who have used methadone in the past and are switching to naltrexone. Those who are still currently using alcohol, on the other hand, can be prescribed naltrexone. 

A Risk Evaluation and Mitigation Strategy (REMS) is required for the long-acting injectable formulation of naltrexone (Vivitrol) to ensure that the benefits of the medication outweigh its risks. The pill form is prescribed daily, but the extended-release injectable formulation is administered once a month.

How Does Naltrexone Work? 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), naltrexone works by blocking the intoxicating and sedative effects of opioids such as codeine, heroin, and morphine. It binds to the opioid receptors in the brain to block the effects of opioids and reduce cravings; however, as a MAUD, naltrexone functions by blocking the endorphin receptors in the body to suppress the effects of drinking. This function reduces alcohol cravings and helps individuals in recovery gradually reduce their alcohol intake. 

Unlike methadone or buprenorphine, naltrexone does not activate opioid receptors during treatment. Hence, it’s considered a relatively safe medication for AUD and OUD. However, it is crucial to remember that naltrexone is not a complete cure for AUD or OUD. Instead, it’s simply a single component in a comprehensive treatment plan that includes counseling, behavioral therapies, and aftercare programs. 

How Is Naltrexone Prescribed? 

Naltrexone dosage is determined by each individual’s medical condition and reaction to treatment. Therefore, the doctor may start naltrexone treatment with a lower dosage and monitor the person for any serious side effects before increasing their dose. 

Naltrexone pills are prescribed in 50 milligrams to be taken once daily. The injectable form of naltrexone (Vivitrol) is administered once a month in 380-mg doses by a healthcare provider. Naltrexone takes effect within 30 minutes after its use. Missing naltrexone doses can reduce its effectiveness and raise the risk of relapse. Naltrexone is not recommended for anyone under the age of 18 or those suffering from certain medical conditions.

Side Effects of Naltrexone 

Similar to many medications, naltrexone has the potential to cause unpleasant side effects. However, the majority of these negative effects are mild and fade away with time.

The following are the more common side effects of naltrexone:  

• Anxiety and nervousness 
• Headaches 
• Loss of appetite 
• Abdominal pain 
• Insomnia 
• Nausea and vomiting 
• Diarrhea 
• Aches 
• Rashes
• Constipation 
• Chills 
• Increased or decreased energy 
• Dizziness 
• Tiredness 
• Ringing in the ears 

If the side effects persist or worsen, it’s vital to speak with your doctor before stopping the medication. Your doctor can help you by changing your dosage or prescribing an alternative medication.

Some of the less common and severe side effects of naltrexone include: 

• Severe injection site reactions 
• Liver toxicity and failure 
• Pneumonia 
• Depressed mood 
• Serious allergic reactions (shortness of breath, swelling of the face, eyes, mouth, or tongue.)

Seek immediate medical attention if you experience any of the following symptoms.

Naltrexone for Alcohol Use Disorder 

Alcohol use disorder is a chronic, relapsing brain disease characterized by the compulsive use of alcohol despite adverse consequences. Naltrexone, as a MAUD, reduces an individual’s motivation to continue drinking. Furthermore, naltrexone has been shown to minimize drinking days in individuals with an AUD and benefit those who struggle with abstinence. Naltrexone functions by: 

• Reducing craving for alcohol
• Suppressing the effects of alcohol
• Reducing the risk of relapse
• Assisting in the improvement of the overall treatment outcome

One of the most significant benefits of utilizing naltrexone is that it has no potential for misuse, addiction, or dependence. Naltrexone aids in the maintenance of sobriety while helping individuals in recovery focus on other areas of treatment.

The duration of naltrexone treatment can vary from one person to another depending on individual requirements and conditions. Naltrexone treatment can last anywhere between 12 weeks to 12 months. Long-term use of naltrexone has not been linked to any concerns thus far. 

Naltrexone is generally prescribed after the individuals have ceased alcohol consumption or completed alcohol detoxification. However, individuals actively consuming alcohol can also take naltrexone for treatment. 

Despite being a relatively safe medication, naltrexone may not be effective for everyone with an alcohol use disorder. Hence it’s vital to consult a physician or addiction specialist to determine the best treatment option for your alcohol use disorder.

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, North Carolina, New Jersey, Ohio, Texas, and Washington.