Naltrexone for Alcoholism and Opioid Addiction

Naltrexone is a drug used primarily in the continued management of alcohol dependence and opioid addiction. How it helps in each case differs. For alcoholism, the treatment can help quell one's desire to drink. In contrast, the drug works to actually thwart the actual effects of opiates on the brain. Naltrexone is sold under the brand names Revia and Depade. A long acting injectable form is marketed under the trade name Vivitrol.

Uses

Naltrexone does not treat alcohol or drug withdrawal symptoms, but can help people who've already stopped using remain drug- or alcohol-free.

For people who've stopped drinking, naltrexone reduces the craving for alcohol that many alcohol-dependent people experience when they quit drinking. It's not fully understood how the drug reduces the craving for alcohol, but some scientists believe it works by decreasing the reinforcing effects of alcohol in certain neural pathways in the brain. Naltrexone blocks certain opioid receptors influencing the neurotransmitter dopamine.

Naltrexone also works to block the effects of opiate drugs like heroin in the brain. As part of a class of drugs known as opiate antagonists, naltrexone competes with these drugs for opiate receptors in the brain to prevent the feelings of pleasure the substances produce.

Effectiveness

Research has shown that naltrexone can reduce cravings for alcohol and drugs for some people, but it doesn't work for everyone. Like most pharmaceutical treatments for alcohol and drug abuse, it works best if used in connection with an overall treatment regime, such as psychosocial therapy, counseling, and/or support group participation.

Naltrexone does not "cure" addiction, but it has helped many who suffer from alcohol or drug addiction to maintain abstinence by reducing their craving for alcohol or drugs.

Indications

Naltrexone is prescribed only after you've stopped taking opioids for seven to 10 days because it can cause serious withdrawal symptoms if taken while you're still using these drugs.

People who have acute hepatitis should not take naltrexone. Patients who are using narcotic painkillers should not take it. Women who are pregnant or breastfeeding should not take naltrexone.

Dosage

In pill form, naltrexone is usually prescribed to be taken once a day. Studies have looked at the use of naltrexone over a 12-week period to help people who have stopped drinking to reduce the craving for alcohol during the early days of abstinence when the risk of a relapse is the greatest, but doctors may prescribe it to be used for longer. Because naltrexone blocks the effects of opioids, it's also sometimes prescribed for extended periods for people trying to manage drug dependence.

In April 2006, the U.S. Food and Drug Administration (FDA) approved a once-a-month injectable form of naltrexone (Vivitrol) for the treatment of alcohol dependence. It also has an indication for opioid dependence. Several studies demonstrated the monthly injection form of naltrexone was more effective in maintaining abstinence over the pill form because it eliminates the problem of medication compliance.

Side Effects

Naltrexone can cause upset stomach, nervousness, anxiety, or muscle and joint pain. Usually, these symptoms are mild and temporary, but for some people, they can be more severe and longer-lasting.

In rare cases, naltrexone causes more severe side effects including:

• Confusion
• Drowsiness
• Vomiting
• Stomach pain
• Skin rash
• Diarrhea
• Blurred vision

Contact your doctor immediately if you experience any of these symptoms. Naltrexone can potentially cause liver toxicity. You should stop taking naltrexone immediately if you experience symptoms such as:

• Unusual bleeding or bruising
• Pain in the upper right part of the stomach
• Dark urine
• Yellowing of the skin or eyes.

Read the full list of symptoms provided with your prescription information.