Naltrexone Treatment for Alcoholism and Opioid Addiction

Maintaining abstinence by eliminating desire

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Man Getting Pill From Bottle
Naltrexone Blocks Effects of Some Drugs.

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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. An extended-release 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. This mechanism involves the neurotransmitter dopamine.

Naltrexone also works to block the effects of opiate drugs like heroin and cocaine 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 drinking alcohol or taking opioids for seven to 10 days because it can cause serious withdrawal symptoms if taken while you're still using drugs.

People who have acute hepatitis, liver disease, or kidney disease should not take naltrexone. Patients who are using narcotic painkillers should not take it nor should anyone who is allergic to any other drugs. 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. 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.

Rapid Detoxification

An implant form of naltrexone is used in a controversial process called rapid detoxification for opioid dependence. In rapid detox, you're placed under general anesthesia and a naltrexone implant is surgically placed in your lower abdomen or posterior. This procedure is usually followed by daily doses of naltrexone for up to 12 months.

The FDA has not approved the implant form of naltrexone. Although the rapid detox procedure is promoted as a one-time "cure" for drug addiction, research has shown that it's really more effective as an initial step in a long-term rehabilitation process.

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
  • Hallucinations
  • Vomiting
  • Stomach pain
  • Skin rash
  • Diarrhea
  • Blurred vision

Contact your doctor immediately if you experience any of these symptoms.

Large doses of naltrexone can cause liver failure. You should stop taking naltrexone immediately if you experience symptoms such as:

  • Excessive tiredness
  • Unusual bleeding or bruising
  • Loss of appetite
  • 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.

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Article Sources
  • Substance Abuse and Mental Health Services Administration. Naltrexone. https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone.