Naltrexone for Alcohol Addiction Treatment

Author: Brittany Tackett

Sometimes, people may need medication-assisted treatment (MAT) to recover from alcohol use disorder (AUD) or prevent relapse.¹ Medications approved by the Food and Drug Administration (FDA), such as naltrexone, can prove beneficial in these treatments.

In this article:

• What is Naltrexone?
• How Does Naltrexone Treat Alcohol Use Disorder?
• Who is a Candidate for Naltrexone Treatment?
• What are the Side Effects of Naltrexone?
• Where Can I Get Naltrexone?

What is Naltrexone?

Naltrexone is an opioid antagonist medication approved by the FDA to treat AUD, as well as opioid use disorder (OUD). Naltrexone is available in pill form or as an intramuscular extended-release injectable.² It is typically offered under the brand names Revia, the pill, and Vivitrol, the injectable.^3,4

How Does Naltrexone Treat Alcohol Use Disorder?

Naltrexone is just one component of a comprehensive MAT program. Research has shown that this medication can reduce alcohol consumption and improve abstinence rates when combined with other treatment options.⁴ However, it works best as part of a whole-person approach that includes behavioral treatment modalities, such as individual and family counseling and peer support groups.²

Because naltrexone is an opioid antagonist, it works by binding to the endorphin receptors in the body and blocking the euphoric effects of alcohol. Alcohol normally increases dopamine and stimulates endogenous opioid release, but naltrexone blocks it from doing so. This helps to reduce alcohol cravings and the overall amount of alcohol consumed.⁴

Who is a Candidate for Naltrexone Treatment?

Naltrexone is not addictive and is generally well-tolerated by most people, making it a highly accessible medication for alcohol addiction.⁴

Naltrexone is not recommended for people under the age of 18 or for those with co-occurring health conditions. To qualify for naltrexone treatment, you must no longer be physically dependent on alcohol or any other substance. Patients will need to complete the alcohol detox process before starting naltrexone to avoid unpleasant side effects, such as nausea and vomiting.² Because naltrexone can cause severe opioid withdrawal symptoms, you should refrain from using opioids for at least seven days before starting naltrexone.⁴

Before Getting Prescribed

If you are considering naltrexone treatment as a medication for alcoholism, talk to your doctor if you:^2,3

• Are pregnant, breastfeeding, or planning to become pregnant
• Take any other medications, vitamins, or supplements
• Have or have ever had clinical depression
• Have liver problems, bleeding problems, kidney problems, or other health conditions
• Take any opioid-containing medications (including certain cough medicines)
• Have allergies to naltrexone or other ingredients in the injectable
• Are dependent on alcohol or opioids or being treated for OUD or AUD
• Plan to have medical treatment or surgery (including dental surgery) soon

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What are the Side Effects of Naltrexone?

Like any medication, naltrexone does have potential side effects that you may experience. Some commonly reported side effects of naltrexone include: ^2,3,5

• Nausea and vomiting
• Stomach pain and cramping
• Diarrhea or constipation
• Constricted pupils
• Headache
• Dizziness
• Drowsiness
• Difficulty sleeping
• Muscle cramps
• Painful joints
• Appetite loss
• Cold symptoms
• Toothache
• Anxiety
• Nervousness
• Irritability
• Tearfulness
• Increased or decreased energy
• Rash

Some more serious side effects that may occur and require a doctor’s support include:^2,3,5

• Depressed mood
• Suicidal thoughts
• Pneumonia
• Blurred vision
• Confusion
• Severe vomiting or diarrhea
• Hallucinations
• Serious liver damage, problems, or hepatitis. Talk to your doctor if you experience any of the following after treatment:
  • Yellowing of the whites of the eyes
  • Abdominal pain that lasts more than a few days
  • Dark urine
  • Light-colored bowel movements
  • Excessive tiredness
• Serious allergic reactions
  • Swelling of face, eyes, tongue, or mouth
  • Skin rash
  • Feeling faint or dizzy
  • Chest pain
  • Wheezing or trouble breathing
• Severe reactions at the injection site. These reactions can be serious and may cause tissue death or require surgery. Contact your doctor immediately if you notice any of the following at your injection site:
  • Swelling
  • Intense pain
  • Hardness around the area
  • Lumps or blisters
  • Open wound or a dark scab
• Risk of opioid overdose among those with a co-occurring OUD. Because naltrexone blocks the effects of opioids, people may take too high of a dose in an attempt to feel an effect, which could lead to an accidental overdose.

Where Can I Get Naltrexone?

Naltrexone can be prescribed and administered by any medical practitioner legally able to prescribe medications. The pill form can be taken daily at home, with or without food, whereas the extended-release injectable is typically administered once every four weeks by a medical practitioner.

Taking Revia

Always take Revia, the pill form of Naltrexone, exactly as prescribed to maintain safety. Patients are encouraged to continue taking the medication even when they feel better. Discuss it with your doctor before choosing to stop treatment. If you miss a dose, take the missed dose as soon as possible unless it is nearly time for your next dose. Do not take a double dose in order to make up for a missed dose.³

Receiving Vivitrol

To receive naltrexone as the injectable, Vivitrol, you’ll need to undergo a Risk Evaluation and Mitigation Strategy (REMS) to ensure that the benefits of the drug will outweigh the potential risks. Naltrexone MAT is meant to be temporary and usually lasts three or four months.² Naltrexone is typically given alone as a medication regimen; however, it is sometimes combined with another medication called acamprosate.⁴

Receiving Naltrexone at Alcohol Rehab

If you choose to attend an alcohol rehab program, you can also receive naltrexone as part of your comprehensive treatment plan. At inpatient rehab, you live at the facility for the duration of your program. There, you will receive an individualized treatment plan comprised of various treatment modalities, such as:

• Individual therapy
• Group counseling
• Family therapy
• Peer support group meetings
• Alternative therapies, such as mindfulness, yoga, and creative arts therapy
• Drug education classes
• Naltrexone
• Aftercare planning

If the naltrexone appears to be beneficial for you and your recovery, your treatment team can help create a plan for you to continue taking this alcohol addiction medication post-rehab.

Conversely, at an outpatient treatment program, you attend therapy at a facility then return home during non-treatment hours (typically, in the evening). Naltrexone may also be a part of your treatment plan at an outpatient program.

If you or a loved one are struggling with alcohol addiction and are considering taking naltrexone or another medication for alcoholism, call 800-948-8417 Calls are forwarded to paid advertisers to speak with an addiction treatment specialist about treatment options today.

Resources

1. National Institute on Alcohol Abuse and Alcoholism. (April 2021). Understanding Alcohol Use Disorder.
2. Substance Abuse and Mental Health Services Administration. (November 2021). Naltrexone.
3. U.S. National Library of Medicine. (2017). Naltrexone.
4. Winslow, B., Onysko, M., & Hebert, M. (March 2016). Medications for Alcohol Use Disorder. American Family Physician, 93(6): 457-465.
5. Food and Drug Administration. (2013). Revia.