Naltrexone is a synthetic drug, not unlike morphine.
It was originally designed to be an opiate antagonist, meaning that it blocks the effects of opiates, but does not activate the corresponding receptors.The result is decreased enjoyment of opiate drugs, as the effects are rendered nearly non-existent. It is commonly used to treat heroin addiction, and is known by the brand names Revia and Vivitrol.
Another effect of naltrexone is reduced pleasure from drinking alcohol, as well as fewer cravings. While the exact mechanism that effectively treats opiate addiction is clear, naltrexone’s affect on alcohol addiction is not. However, it is believed to be related to activity in the dopamine pathway, a primary pleasure center in the brain thought to be activated by most major drugs.
Naltrexone can be administered in three different ways – orally, via injection, or implant.
Naltrexone in tablet form is typically prescribed at 50mg per day for alcohol dependence. For opiate dependence, opiates must be abstained from for at least 7-10 days before administering the initial dose of 25mg. In the absence of withdrawal symptoms, 50 mg per day is then recommended. Higher doses, including 100mg or 150mg, may be alternated based on need.
Injected Naltrexone (Vivitrol)
Naltrexone can be administered once per month as a intramuscular gluteal injection (380mg) for either alcohol or opiate dependence. One of the main benefits of injection is that the patient cannot accidentally or intentionally miss a dose.
The Naltrexone Implant
The naltrexone implant is inserted into the lower abdomen, releasing a controlled amount of medication into the body over the course of 3-6 months. Like the injection, the naltrexone implant eliminates the need for the patient to stick to a regime, which may result in missed doses or refusal to ingest. Unfortunately, only Russia has approved the naltrexone implant for use in a clinical setting. However, it is available in the United States in private rehab centers.
Naltrexone, in any form, typically has minimal, non-serious side effects of relatively short duration. These include anxiety, diarrhea, dizziness, fatigue, headache, insomnia, nausea, and sleepiness. For alcohol dependence, nausea is usually the worst symptom, but may also include withdrawal symptoms related to sudden abstinence.
What Naltrexone Does Not Do
Naltrexone, in any form, is not meant to be a cure-all. It does not take the place of individual or group therapy, but is best when used in conjunction with a comprehensive treatment program. It can help break the cycle of alcohol or drug dependence from a biological angle, but it does not erase trauma or underlying mental conditions (such as depression) that contributed to the addiction in the first place.
Additionally, it does not block the effects of intoxication from alcohol use, and is not recommended for pregnant women or patients with liver or kidney disease.
Patients report feeling little effect of the drug, in that it does not make one feel either high or low or alter perception. It is for this reason that it is not considered addictive.
If you or someone you know is addicted to opiates or alcohol, please seek help immediately.