How is Naltrexone Useful for Alcohol Treatment?
After initial treatment, many of those treated for alcohol dependence fall back into old habits and begin drinking again. Naltrexone is an opiod antagonist, labeled by the FDA since 1984, that helps those with long-term alcohol dependence avoid relapse by preventing some of the pleasurable feelings that the dependent person would feel when they are drinking. With the pleasurable feelings reduced, the craving for alcohol is also reduced. The same effect is helpful for recovering opiate addicts as well.
Naltrexone is usually utilized in conjunction with therapy and social support such as CRAs and in most cases, cannot be prescribed in the absence of some form of psychosocial support such as counseling sessions or support groups.
Does It Work?
In a Scottish study, those treated with Naltrexone had 34% recovery rates compared to those receiving a placebo, who experienced 25% recovery rates.1 The Merck Manual of Geriatrics reports that Naltrexone “can reduce relapse rates by 50% when combined with psychosocial intervention.”
Is It An Approved Drug?
Sold under the brand names Revia and Trexan, Naltrexone is licensed in Ireland and several European Union countries for alcohol dependence since 1996. It is licensed for those suffering alcohol dependence by the Food and Drug Administration in the United States. It is not yet licensed for alcohol dependence in the UK.
Opiate Detoxification with Naltrexone
International studies have shown that naltrexone can be used to reduce opiate dependence quickly, but withdrawal symptoms will continue even while using naltrexone.  The European Union published a study [link 2] which compares two types of rapid drug detoxification from opiates using naltrexone. Some studies using naltrexone have been compromised by lack of compliance among the study participants in taking naltrexone, so further studies have found success when combining naltrexone with a Community Reinforcement Approach (CRA) as the recovering addict continues to receive outpatient care following initial withdrawal. The Community Reinforcement Approach is a cognitive-behavioral program used to treat recovering drug addicts.
Will I Experience Withdrawal?
While Naltrexone will help you stop taking drugs or alcohol, it will not prevent withdrawal symptoms. Naltrexone may cause or worsen withdrawal symptoms. For this reason, if you are already experiencing withdrawal, you should not take Naltrexone.
How Do I Take Naltrexone?
Naltrexone can be in pill or injectable form. It can be taken at home or in a clinical setting, and the usual dose is 50 mg/day. The usual regimen for Naltrexone is once a day, with or without food. Naltrexone is only effective if you continue taking it, even if you feel that you are no longer addicted.
A monthly injectable form of Naltrexone, Vivitrol, is currently being studied by researchers. This can reduce non-compliance that often prevents Naltrexone from working for many patients.
Can I Continue to Take Drugs While on Naltrexone?
Since Naltrexone reduces the effects and feelings you receive from opiod drugs, if you continue taking drugs you could accidentally overdose.
What About Antabuse?
Antabuse is another drug that reduces pleasurable effects of alcohol for alcoholics. Naltrexone is more effective than Antabuse. Naltrexone and Antabuse are the only two drugs approved to treat alcohol dependence in the United States.
The most common side effect is nausea, occurring in 10 to 15% of Naltrexone patients, and headache, which affects 7% of patients.
When taken in larger-than-normal doses, naltrexone can cause liver damage. It is unlikely that when taking prescribed doses, a patient would experience liver damage. If you have ever had a liver disease or damage, inform your doctor since this may affect whether you should take naltrexone. If you experience any unusual symptoms while taking naltrexone, contact your doctor immediately.
- NHS Health Quality Report on Alcohol Dependence which has a section on naltrexone
(very large file)
- Roozen HG, Kerkhof AJFM, van den Brink W:
Experiences with an Outpatient Relapse Program (Community Reinforcement Approach) Combined with Naltrexone in the Treatment of Opioid-Dependence: Effect on Addictive Behaviors and the Predictive Value of Psychiatric Comorbidity.
Eur Addict Res 2003;9:53-58 (DOI: 10.1159/000068808)
- Merck Manual of Geriatrics, Chapter 37