When someone struggles with moderate to severe alcohol or opioid addiction, medication-assisted treatment (MAT) may be recommended during rehab to reduce cravings, prevent relapse, and help clients change how they think about substance use.
Naltrexone is a common choice for MAT because it’s non-addictive and several clinical trials point to its effectiveness. It doesn’t replace a well-rounded rehab program that consists of therapy, lifestyle changes, and relapse prevention planning. However, it can be a helpful tool in the recovery process.
We’ll explain everything you should know about MAT with Naltrexone in the rest of this article, including what it is, how it’s used, and how we integrate it into alcohol addiction treatment and opioid addiction treatment at United Recovery Project.
What Is Naltrexone?
Naltrexone is known as a narcotic blocker or opioid antagonist. It works by blocking the euphoric and sedative effects of opioids and alcohol. Therefore, if someone in addiction treatment were to drink or take opioids, they wouldn’t feel any effects. That can help those recovering from addiction change how they think about substance use.
Naltrexone is an FDA-approved medication for alcohol use disorder (AUD) and opioid use disorder (OUD). It isn’t addictive and doesn’t produce a high when someone takes it.
Typically, you’ll see naltrexone available in two forms: a pill that’s taken daily or a monthly injection. The pill form of naltrexone is usually labeled under the brand name Revia and the injection is usually under the brand name Vivitrol.
How Naltrexone Works
When someone takes substances like prescription opioids, heroin, or alcohol, it interacts with receptors in the brain, such as opioid receptors. That interaction causes the release of large amounts of “feel-good” hormones like dopamine and serotonin and is why taking drugs or drinking feels pleasurable.
As someone takes those substances in high doses for a longer duration of time, their brain can become accustomed to the drug triggering the release of those hormones, slowing its natural production of them. Therefore, when they suddenly stop drinking or using drugs, they feel like they can’t function normally and crave the substance.
Taking a medication like naltrexone reduces the positive sensation associated with alcohol or opioid use. It works by blocking opioid receptors and dampening the reward system associated with drinking. Then, when someone uses opioids or drinks alcohol they’ll feel little to no effects from the substance.
Essentially, it can be used in addiction treatment to break the psychological reinforcement loop associated with relapse. When someone stops feeling the pleasurable effects related to substance use, their cravings begin to reduce and it makes it easier to form better habits.
A Well-Rounded Treatment Program is Still Necessary
Naltrexone or other medications used for MAT aren’t a quick fix for addiction. Recovery still requires work and well-rounded addiction treatment to build healthy habits that lead to long-term success. Therefore, seeking a program that consists of therapy, life skill building, and lifestyle change alongside MAT is a good idea to maintain ongoing sobriety.
Naltrexone for Alcohol Use Disorder
Now, you may still wonder, how does naltrexone work specifically for AUD? Taking naltrexone blocks the parts of your brain that feel pleasure from drinking alcohol, specifically, the endorphins released in the brain when drinking. When someone stops feeling the pleasurable effects of drinking alcohol, it makes it easier to break the habit.
Several clinical trials have shown that naltrexone is an effective treatment method for AUD. One study published in 2022 found that a 50 mg dose reduced binge drinking, the number of drinks consumed, and cravings while recovering from alcohol addiction. The effects were even sustained at 6 months post-treatment.
How Naltrexone Compares to Other Medications for AUD
There are two other FDA-approved medications for AUD: acamprosate and disulfiram.
Acamprosate can reduce alcohol cravings and promote balance in key neurotransmitters like GABA and glutamate. However, acamprosate doesn’t block the effects of alcohol like naltrexone does.
Disulfiram will make someone feel physically ill when they drink alcohol. That can consist of symptoms like nausea, sweating, or skin flushing. These symptoms can be very uncomfortable so it’s best for highly committed clients, whereas naltrexone can be easier to handle since it simply blocks the effects of alcohol.
It’s best to consult with medical treatment professionals to determine the right type of medication for you.
Naltrexone for Opioid Use Disorder
Naltrexone blocks opioid receptors. Therefore, when someone uses opioids while taking the medication, they won’t feel euphoric or pleasurable effects. It can help alter how someone feels about opioid use and build positive habits during treatment.
When using naltrexone for opioid addiction, it’s recommended to use it after initial detox and stabilization. Studies show that taking it before detox can cause precipitated withdrawal, which is a rapid onset of moderate to severe withdrawal symptoms that become very uncomfortable.
However, when using naltrexone correctly, several clinical trials show it has positive effects. A systematic review of 18 studies that included a total of 2,280 participants showed that using naltrexone during OUD rehab led to 63% higher treatment retention than control groups.
How Naltrexone Compares to Other Medications for OUD
When comparing naltrexone vs. suboxone and methadone (two other common medications for OUD), the use case is the main difference.
Suboxone and methadone are typically used during detox to ease withdrawal symptoms. They’re often recommended to patients who are more likely to experience moderate to severe withdrawals. Whereas naltrexone is only recommended after detox.
Any of these medications can be effective. A medical treatment team can help determine which is best for your needs.
Who Should and Shouldn’t Use Naltrexone?
Naltrexone isn’t right for everyone, and its use depends on individual needs.
Who It’s Best For
Naltrexone is best for people who have:
- Completed detox – To prevent precipitated withdrawal symptoms.
- Are motivated to stay clean – It requires accountability to keep taking the medication and following a treatment program to have the desired effects.
- No liver damage or acute hepatitis – Naltrexone may have side effects for those with liver disease or acute hepatitis.
Who Shouldn’t Use It
Naltrexone isn’t recommended for:
- Anyone still dependent on opioids – Due to the rapid onset of withdrawal symptoms it can cause.
- People with liver disease – It could cause side effects or worsen symptoms.
- Pregnant individuals – There’s a risk of fetal harm while taking it during pregnancy.
Common Side Effects & Safety
While naltrexone is considered safe and well-tolerated for most, medical supervision is still recommended during use. Some side effects that could occur while taking it are:
- Nausea
- Headache
- Fatigue
- Anxiety
- Sleep disturbances
- Joint pain
- Anxiety
- Skin rashes
Some rare cases have also reported liver damage, especially in those with liver disease. It’s best to monitor liver enzymes during use to ensure safety.
Additionally, some rare but severe side effects have been reported like breathing problems, hallucinations, suicidal thoughts, or irregular heartbeat, which is why medical supervision is essential to ensure safety during use.
How United Recovery Project Uses Naltrexone in Treatment
At United Recovery Project, we offer individualized MAT plans for alcohol and opioid addiction when appropriate. Our medical staff assesses each new client’s drug and alcohol use history and physical health before prescribing naltrexone or any other medications.
We always combine MAT with a full addiction treatment program to ensure the best results. That includes therapy, holistic care, education, and life skill building to improve overall well-being and facilitate sustainable lifestyle change.
Our team is there with you each step of the way. That way, whether you have concerns about MAT or need additional support, you won’t feel like you have to face treatment alone.
Conclusion
Naltrexone is a medication that can help treat alcohol and opioid addiction. It doesn’t replace a well-rounded rehab program, but it can be an effective tool to facilitate recovery.
If you’re researching treatment options for yourself or a loved one, we can offer guidance at United Recovery Project. Contact us today to learn more about MAT and how our personalized drug and alcohol treatment programs can help.
References
- Singh, Dharminder, and Abdolreza Saadabadi. “Naltrexone.” PubMed, StatPearls Publishing, 2023, https://www.ncbi.nlm.nih.gov/books/NBK534811/
- Avery, Jonathan. “Naltrexone and Alcohol Use.” American Journal of Psychiatry, vol. 179, no. 12, 1 Dec. 2022, pp. 886–887, doi:10.1176/appi.ajp.20220821. https://psychiatryonline.org/doi/full/10.1176/appi.ajp.20220821
- Witkiewitz, Katie, et al. “Acamprosate for Treatment of Alcohol Dependence: Mechanisms, Efficacy, and Clinical Utility.” Therapeutics and Clinical Risk Management, vol. 8, Feb. 2012, p. 45, doi:10.2147/tcrm.s23184. https://pmc.ncbi.nlm.nih.gov/articles/PMC3277871/
- Stokes, Maranda, and Sara Abdijadid. “Disulfiram.” National Library of Medicine, StatPearls Publishing, 24 Oct. 2022, https://www.ncbi.nlm.nih.gov/books/NBK459340/
- Hassanian-Moghaddam, H., et al. “Withdrawal Syndrome Caused by Naltrexone in Opioid Abusers.” Human & Experimental Toxicology, vol. 33, no. 6, 1 June 2014, pp. 561–567, doi:10.1177/0960327112450901. https://pubmed.ncbi.nlm.nih.gov/23690227/
- Zangiabadian, Moein, et al. “The Effects of Naltrexone on Retention in Treatment and Being Opioid-Free in Opioid-Dependent People: A Systematic Review and Meta-Analysis.” Frontiers in Psychiatry, vol. 13, 26 Sept. 2022, doi:10.3389/fpsyt.2022.1003257. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.1003257/full
- WebMD. “Drugs & Medications.” Webmd.com, 2019, https://www.webmd.com/drugs/2/drug-7399/naltrexone-oral/details
