Naltrexone medication plays a powerful role in addiction treatment. The Food and Drug Administration (FDA) originally approved the drug as a treatment for alcoholism. Over time, researchers have found that it can also be used to help addicts abstain from opiate drugs. Low dose naltrexone (LDN) may even help treat chronic behavior disorders, like compulsive eating. LDN is also effective in getting rid of certain infections and as a cancer treatment. This prescription medication is versatile in its uses. Not only can it do all of the things mentioned above, but, best of all, it’s also non-addictive and not a narcotic.
What is Naltrexone?
In the 1980s, the FDA officially approved Naltrexone for treating heroin and opium addiction. This medication is prescribed after detox and, so far, has been highly successful and effective. It’s become a critical component in addiction recovery and comes with minimal health risks. Naltrexone can be administered either in pill form or as an extended-release injectable known as Vivitrol. Patients can recover from opiate addiction, alcoholism, or weight loss by taking the slow-release version of the drug. It comes in a 50 mg dose for treating addiction or an even lower dose for normalizing the immune system. It is highly effective in preventing drug and alcohol relapse.
Why is Naltrexone Such a Powerful Addiction Treatment?
Naltrexone has many facets in treating addiction. When combined with clonidine, it aids in the heroin or methadone detox process. This can be a major cost saver to the state and to the individual seeking addiction treatment. Naltrexone HCL is an oral medication with long-acting opioid-blocking capabilities. It was originally marketed for heroin addiction. The Special Action Office for Drug Abuse Prevention initiated the creation of this drug in the 1980s. NIDA was on board with this initiative and put together clinical studies to study the side effects of naltrexone. NIDA determined that it has no organ or developmental toxicology. When compared to a placebo, this drug also yielded superior results for treating heroin abuse. Finally, in 1995, it was approved for preventing relapses in alcoholics trying to recover.
Various Prices of Naltrexone
The price of naltrexone HCL varies depending on the brand and type. There are 50mg, 100mg, and 150mg naltrexone tablets. There is also an extended-release injectable suspension that is good for a month.
Revia, the brand name version of naltrexone, costs the most. There are a variety of generic tablets that cost less.
Naltima, a 50 mg tablet, costs about $25 for 10 tablets.
The price of generic Revia on some websites or at some stores may cost less than the actual brand name. For example, some places offer 30 tablets of generic Revia, containing 50 mg of naltrexone, for $31.50.
The price of VIVITROL® is substantially higher than the tablets. The plus side is that it’s much easier for people to use this type of medication because they don’t have to remember to take pills every day.
The price of VIVITROL® ranges from $1,300–$1,700 per injection. There are co-pay savings programs that will cover up to $500 per month. Not all patients are eligible for this program, as eligibility depends on the insurance carrier.
Naltrexone Uses
Naltrexone is a critical part of many addiction recovery treatment plans. This non-narcotic opiate blocker can stop addicts from using certain drugs or alcohol. It’s unique within the medical industry because it’s non-addictive. It also prevents users from feeling high or from feeling the effects of alcohol. This takes away the reward process of using substances in the first place. The reward is a powerful motivator that keeps addicts hooked. Naltrexone takes that aspect away from drug abuse or alcohol abuse.
Naltrexone is an effective treatment for alcohol dependence. As mentioned above, it stops the pleasurable sensations that alcoholics associate with drinking. It isn’t a drug or alcohol substitute like many other addiction drugs. It reduces alcohol cravings, which can result in an alcoholic drinking less or stopping altogether. Think of this medication as an aid to recovery from drug addiction or alcoholism, not a cure. It should be used in conjunction with other types of substance abuse treatments, including holistic healing and behavioral therapy.
What is Naltrexone, and How Does it Work?
Naltrexone is an opiate blocker. It belongs to the drug family known as opiate antagonists. It works by blocking serotonin and dopamine from attaching to cells or nerve receptors in the brain, spine, or gastrointestinal tract. The result is that the user will feel no effect from opiate drugs or alcohol. It stops the strong cravings that cause people to relapse.
Naltrexone was originally sold under the brand name Revia in pill form. It is now also available as a once-a-month injectable, administered by a licensed physician or other healthcare professionals in outpatient treatment settings. Those who drink while on naltrexone can still become intoxicated, but they won’t feel the same pleasurable feelings as before; in fact, they’ll feel sick.
No one knows exactly what mechanism of action causes these effects, but naltrexone effectively inhibits further alcohol or drug abuse. It successfully treats patients by:
Reducing an alcoholic or drug addict’s urge to use.
Helping addicts abstain from the substances they’re addicted to.
Blocking an addict’s desire to drink more if they do have a drink.
Withdrawal Symptoms and Naltrexone
There’s a dynamic relationship between this medication and the opioid receptors in your central nervous system (CNS). Naltrexone can prevent impulsive actions that lead to relapse and help those already in recovery. Patients must already be on their sobriety journey before using this prescription drug.
A common question is: “Does naltrexone help with withdrawal symptoms?” The answer is both yes and no. It helps treat psychological withdrawal symptoms, like cravings, but it does not treat physical withdrawal symptoms, such as seizures or delirium tremens. It must not be used while alcohol or opioids are still present in the body.
Naltrexone users can stop using it without worrying about withdrawal symptoms because it does not lead to physical or chemical dependence, unlike methadone or buprenorphine.
How Long Does It Take for Naltrexone to Start Working?
Naltrexone’s effects will usually kick in within minutes of ingestion or injection. The effects tend to activate faster if the drug is injected, as it can quickly travel to opioid receptors in the organs. Within minutes, most patients typically find that they no longer have a craving or need to drink alcohol or use drugs. These cravings can be drastically reduced or eliminated entirely.
Naltrexone effects also kick in with the first dose. If injected, the effects last for an entire month. It’s important for patients to continue using this medication to achieve a full recovery, even after the effects start. Although recovering substance abusers are not expected to take naltrexone for long periods, most will need it for a couple of weeks, allowing time for their body and brain to reset.
What is Low Dose Naltrexone (LDN)?
LDN is a low-dose version of naltrexone, FDA-approved to normalize the immune system. This is effective for people with HIV/AIDS, cancer, CNS disorders, or autoimmune diseases. Low-dose naltrexone is also a low-cost treatment option for people living in developing countries. For example, in Africa, LDN can be used as an affordable therapy for HIV and AIDS. It is beneficial because it comes with no side effects.
LDN blocks the receptors responsible for producing opioid hormones in the brain and adrenal glands. By doing this, it stimulates the immune system, which enhances the body’s ability to fight conditions like HIV or cancer. LDN has also been noted to effectively control autoimmune diseases such as lupus. In short, LDN boosts the body’s defense system.
What Other Situations Can Low Dose Naltrexone Be Prescribed For?
While naltrexone is primarily used to treat opioid and alcohol addiction, LDN has proven to be much more versatile. LDN can be prescribed for cancer treatments like lymphoma and pancreatic cancer. For example, a study of 354 cancer patients found that 86 patients experienced “significant tumor shrinkage” by at least 75%, and 125 patients’ conditions stabilized after using LDN.
LDN can also be prescribed for various autoimmune conditions such as:
HIV
Lymphoma
Fibromyalgia
Crohn’s disease
LDN has also shown promise in improving the symptoms of Post Traumatic Stress Disorder (PTSD), making it helpful in treating co-occurring disorders by stabilizing a patient's mood during recovery.
Naltrexone for Alcoholics
Naltrexone works by helping individuals drink less alcohol or abstain completely. It makes drinking less desirable and is best used as part of a complete treatment plan, which includes counseling, support groups like 12-step programs (AA), and lifestyle changes.
Alcohol dependence affects a person on multiple levels—physically and psychologically. The physical addiction involves increased tolerance, requiring the person to consume more alcohol to avoid withdrawal symptoms. Naltrexone reduces cravings, which helps prevent relapse and makes recovery more manageable. Clinical trials have shown that naltrexone effectively limits both the number and the duration of drinking days among alcoholics.
Can You Drink Alcohol While Taking Naltrexone?
You can drink alcohol while taking naltrexone, but the drug will not sober you up or cause any dangerous side effects. However, it will reduce the pleasurable effects of drinking, which may decrease the urge to consume more alcohol. It is not a form of aversion therapy like disulfiram (Antabuse), but it can still reduce alcohol intake. Due to this unique mechanism, researchers are exploring the merits of the Sinclair Method, which suggests taking naltrexone one hour before drinking to help reduce cravings.
Naltrexone will not prevent any short-term or long-term effects of alcohol consumption, such as the risk of cardiovascular damage, kidney damage, or developing conditions like dementia or delirium tremens.
Naltrexone for Opiate Addiction
Opioids, like heroin, create a euphoric effect that encourages continued use. Naltrexone blocks these effects, reducing the motivation for drug use. While users can still attempt to use heroin or prescription opioids while on naltrexone, they will not experience the same high, which helps in terminating opioid abuse.
Naltrexone is a potent mu-opioid antagonist and is regarded as a favorable method for encouraging recovery, as it carries little risk and no potential for abuse. However, naltrexone administration should be part of a broader treatment plan, which may include detoxification, rehabilitation measures, compliance monitoring, counseling, and lifestyle changes.
The Danger of Continuing to Abuse Opioids While Taking Naltrexone
If an individual continues to abuse opioids while on naltrexone, they will not experience any pleasurable effects. However, this lack of effect may lead some users to increase their dosage in an attempt to get high, which increases the risk of overdose. Although naltrexone blocks the euphoric effects of opioids, it does not prevent the drugs from causing harm, potentially leading to coma or death. Naloxone can reverse the effects of an opioid overdose, but immediate medical attention is still required.
Side Effects of Naltrexone and Current Use of Opiates
Naltrexone has few side effects, but mixing it with opiates can trigger immediate withdrawal symptoms, as naltrexone blocks the effects of opioids in the brain. This is why patients often carry a card indicating they are on naltrexone, allowing healthcare providers to adjust pain medications accordingly.
Patients should discontinue naltrexone three days before elective surgery, as opiates used for pain relief will not be effective while the drug is still in the system.
Naltrexone does not interfere with antibiotics or non-opioid painkillers. However, it is broken down by the liver, so patients with liver conditions should monitor liver function and adjust their dosage if necessary.
Sudden Opioid Withdrawal
Anyone interested in taking naltrexone must be opioid-free for at least 7 to 14 days. Failure to do so can lead to sudden opioid withdrawal, a condition that may require hospitalization. Symptoms of sudden opioid withdrawal include:
Nausea
Headaches
Anxiety
Fatigue
Abdominal cramps
Restlessness
Bone/joint pain
Muscle aches
Runny nose
To avoid sudden withdrawal, patients must ensure they are opioid-free before taking naltrexone. Most rehab centers can help manage withdrawal symptoms and ease the process.
Why Does Naltrexone Work for Weight Loss?
As of 1995, the FDA approved naltrexone for treating alcohol abuse. Naltrexone has also proven effective in managing impulse control disorders, like eating disorders. The FDA-approved weight loss drug combines naltrexone with bupropion, where bupropion suppresses appetite and prevents depression, while naltrexone reduces hunger and food cravings.
Naltrexone, in its low-dose form, can be used as a weight-loss medication on its own, although this treatment plan is not FDA-approved. LDN can promote weight loss by:
Reducing insulin resistance and improving insulin sensitivity
Stimulating hormone growth, which improves lean muscle mass production
Regulating food intake based on energy expenditure
Improving sleep, which moderates blood sugar levels and manages inflammation
Enhancing thyroid function
What is Naltrexone 50 mg Used For?
Addiction specialists may prescribe a 50 mg dose of naltrexone for treating addiction, usually taken daily. It blocks the physiological effects of heroin, morphine, and alcohol for 24 hours. After detox, patients in inpatient programs are monitored to ensure adherence to their prescription schedule. For outpatient treatment, higher doses (100 mg or 150 mg) may be prescribed, allowing patients to visit the clinic every 2–3 days.
Naltrexone HCL
Naltrexone HCL refers to the hydrochloride form of naltrexone, making it easier for the body to absorb. The hydrochloride also makes the medication more stable and longer-lasting.
Extended-Release Naltrexone (Vivitrol)
Instead of taking tablets, patients may opt for Vivitrol, an extended-release version of naltrexone. Vivitrol is administered via a monthly intramuscular injection and is non-addictive. The same dose is used for every patient, regardless of the severity of their alcohol or opioid abuse history. Vivitrol creates a barrier that blocks opioid molecules from attaching to receptors in the brain.
Patients must detox before taking Vivitrol, as having alcohol or opioids in their system can cause adverse effects.
Benefits of Choosing Vivitrol Over Other Types of Medications
There are several reasons why addiction specialists recommend Vivitrol over other treatment methods:
Non-addictive: There is zero potential for abuse, and patients won’t develop a secondary addiction.
Easy to administer: Vivitrol is a once-a-month injection, with the same dose for all patients.
Goal of total abstinence: Vivitrol helps patients achieve total abstinence by blocking the effects of alcohol or opioids.
Long-lasting: Vivitrol’s effects last an entire month, whereas other treatments, like buprenorphine, last for about 24 to 60 hours.
Higher adherence rate: Patients are more likely to stick to a simple schedule, which improves their chances of recovery.
Fewer side effects: Patients experience minimal discomfort during recovery, making the process more manageable.
Vivitrol treatment typically lasts between 6 months and a year, providing ample time for the body to reset.
Other Addiction Treatment Medication Options
Naltrexone is not the only medication available for treating opioid or alcohol addiction. There are several alternatives. Those struggling with opioid or opiate abuse may be eligible for Opiate Replacement Therapy (ORT), while individuals dealing with alcohol abuse may qualify for Medication-Assisted Treatment (MAT).
Opiate Replacement Therapy (ORT)
ORT involves the use of weaker opioids, such as methadone, Suboxone, and buprenorphine. These medications stimulate the same opioid receptors, preventing intense withdrawal symptoms. They are easier to manage and taper off.
ORT is divided into two types: full opioid agonists and partial opioid agonists.
Full opioid agonists, like methadone, work in the same way as heroin, stimulating the same receptors and producing similar effects. These drugs can be just as addictive, and patients may get high if they take increasing doses. Due to this risk, patients must strictly follow the prescribed schedule.
Partial opioid agonists, like Suboxone, have a maximum threshold. Patients will not get high even if they increase their dose, and they are less likely to develop dependence. Once a certain dose is reached, taking more of the drug will not produce any additional effects.
Medication-Assisted Treatment (MAT)
MAT involves the use of medications that ease withdrawal symptoms without being addictive. MATs can treat specific symptoms and are available for both opioid and alcohol addiction. Medications used to treat alcohol addiction include:
Acamprosate
Disulfiram
These medications work in different ways and must be tailored to the patient's biological makeup.
Naltrexone Side Effects
Naltrexone has minimal side effects. Less than 10% of individuals report the following side effects:
Headaches
Depression
Nausea
Fatigue
Insomnia
Anxiety
Most patients find that if they do experience side effects, they are not intense and do not last long.
The only serious side effect to be cautious about is liver damage or hepatitis. To prevent significant liver damage, patients are encouraged to get regular blood tests to monitor liver function. Signs of liver problems include:
Stomach or abdominal pain lasting more than a few days
Dark urine
Extreme fatigue or tiredness
Yellowing of the whites of the eyes
Patients may need to stop taking naltrexone if it is causing liver damage. However, doctors will weigh the benefits and risks of continuing treatment, and in many cases, the benefits of preventing alcohol or drug abuse outweigh the risks associated with naltrexone.
Conclusion
Naltrexone is a powerful tool in fighting addiction, helping prevent relapse without being addictive itself. It can be combined with other treatments, as long as the patient is not taking opioids or drugs that affect liver function. This medication is a critical addition to any substance abuse treatment plan, which should also include counseling, 12-step programs, holistic healing (like meditation), and one-on-one therapy. Unlike some other addiction medications, there is no need to taper off of naltrexone, and patients will not develop dependence on it.