Naltrexone for Alcoholism and Opioid Addiction

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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.


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.

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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.


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.


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.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database

3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733

  2. Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues Clin Neurosci. 2007;9(4):455-70. PMID:18286804

  3. Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2009. (Treatment Improvement Protocol (TIP) Series, No. 49.) Chapter 4—Oral Naltrexone. 

Additional Reading
  • Substance Abuse and Mental Health Services Administration. Naltrexone.

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.