Naltrexone for Alcohol & Opioid Use Disorder: Side Effects, Uses & Interactions
Naltrexone is a medication that may be prescribed to treat people who are recovering from alcohol use disorder (AUD) or opioid use disorder (OUD).1
If you or a loved one is struggling with compulsive drinking or opioid use, naltrexone may be prescribed as part of your treatment. This page will help you understand how naltrexone works, what it is used for, and how to find treatment that works for you.
What Is Naltrexone and What Does it Do?
Naltrexone may be administered as a daily oral medication or as an injectable solution. Naltrexone is available in both generic and brand name formulations, including Vivitrol—an extended-release, intramuscular injection administered every four weeks.1,2
It works by blocking the rewarding effects of opioids and alcohol at opioid receptors throughout the brain, which helps to reduce cravings and minimize the reinforcement of continued use of these substances.3
How Does Naltrexone Treat Addiction?
Naltrexone for alcohol or opioid addiction can be an effective component of comprehensive treatment plans for people struggling with AUD and/or OUD.2 It can support a person’s sobriety by managing cravings and reducing the rewarding effects associated with opioid or alcohol use.5,6
An individualized treatment plan that includes naltrexone for alcohol or opioid use disorders should ideally include additional components such as counseling and behavioral therapies to address underlying issues and provide the optimal chances of sustained recovery.6, 7
How Naltrexone Helps with Opioid Use Disorder
Naltrexone for opioid use disorder is designed to prevent a return to opioid use following medically-supervised withdrawal or in those who have otherwise not used any short-acting opioids for at least 7–10 days and long-acting opioids for at least 10–14 days. Because it has no potential for misuse and does not cause opioid-like effects itself, naltrexone addiction is not a concern.6
Naltrexone helps to block some of the rewarding euphoria associated with opioid misuse and may also help mitigate cravings for opioids.1 This means that if a person in recovery from opioid use disorder consistently takes naltrexone, they may be more likely to maintain abstinence.6
How Naltrexone Helps with Alcohol Use Disorder
Naltrexone for AUD works by helping to reduce short-term heavy drinking and alcohol consumption, the number of heavy drinking days, and cravings for alcohol.5,8 It is prescribed in two formulations: oral naltrexone is taken once per day, while the injectable, sustained-release formulation is provided only to those who can refrain from drinking for several days before they start using it.7
Who Is a Good Candidate for Naltrexone?
People who may be good candidates for naltrexone for AUD include those who:7
- Are medically stable.
- Are not in acute alcohol withdrawal.
- Can refrain from drinking for several days before treatment initiation.
- Experience intense alcohol cravings.
- Have co-occurring OUD.
- Have a family history of AUD.
People who may be suitable for naltrexone for OUD include those who:
- Have completed detox to avoid precipitating severe opioid withdrawal symptoms.6
- Have abstained from short-acting opioids for at least 7–10 days and long-acting opioids for at least 10–14 days.6
- Do not have severe liver impairments.6
Effectiveness of Naltrexone for Substance Use Disorders
The effectiveness of naltrexone can depend on several factors, but it is generally viewed as an effective treatment, particularly when combined with behavioral therapies and counseling.5
Some of the benefits of naltrexone include the following. Naltrexone:5
- Reduces cravings for opioids/alcohol.
- Naltrexone can be as effective as buprenorphine (when taken consistently by those who choose not to be on opioid agonist maintenance for OUD) for treatment retention and decreased illicit opioid use, .6
- Is safe with few side effects.8
- Enhances the effectiveness of behavioral therapies.
- Can be used alongside other non-opioid medications.
- Can be stopped abruptly without a tapering schedule.
- Can be taken over long periods if desired and helpful.
Is Naltrexone Addictive?
No. Naltrexone has no misuse potential and is not addictive.6
Side Effects of Naltrexone
As with any medication, naltrexone may have certain side effects, but it is generally well-tolerated by most people.7
The most common naltrexone side effects include:
- Nausea and vomiting.7
- Dizziness.1
- Sedation.1
- Sleep changes.1
- Injection site reactions (with extended-release injectable use).1
Naltrexone Precautions
There are certain considerations to keep in mind before starting naltrexone.
- Opioid tolerance may decrease while taking naltrexone, leaving people more vulnerable to opioid overdose after discontinuing treatment or missing a dose.1
- Extended-release naltrexone may be associated with liver inflammation and hepatic enzyme abnormalities. Use may be contraindicated in some people with pre-existing liver issues.3,6
- Naltrexone may be contraindicated for use during pregnancy and breast-feeding.2,6
Finding the Right Treatment for You
Medications for AUD or OUD can be an important part of a comprehensive addiction treatment program to help people start and stay on the path to recovery. American Addiction Centers (AAC) is a leading provider of individualized, evidence-based treatment for AUD and OUD, with rehabs located across the nation. Many of our centers offer medications for addiction treatment, and we can help you find the right program for your needs.
Frequently Asked Questions
