Naltrexone (ReVia, Vivitrol) is a medication FDA-approved for the treatment of opioid and alcohol dependence. Many health organizations recommend naltrexone for fully detoxed persons from alcohol or opioids and are highly motivated to maintain abstinence.
Although naltrexone can be a helpful addition to an individual’s recovery process, it is not, by any means, a surefire cure. To be effective, naltrexone must be used in conjunction with psychotherapies and other treatment modalities, such as cognitive-behavioral therapy, counseling, and 12-step programs, such as Alcoholics Anonymous and Narcotics Anonymous.
How Does Naltrexone Work?
Naltrexone is in a class of medications known as mu-opioid receptor antagonists. Signaling within the brain and between the brain and body takes place with the assistance of neurochemicals. These chemicals are released by specialized cells throughout the central nervous system that enact their effects by attaching to different receptors.
When opioid-type neurochemicals, such as endorphins bind with the mu-receptor, a signal is sent that alters a person’s perception of pain. This molecular interaction may initiate additional signaling that results in accompanying pleasant, relaxing, or euphoric sensations.
Naltrexone works by blocking mu-opioid receptors so that other substances are unable to bind to them. When these mu-opioid receptors are blocked, signaling mechanisms are altered. The perception of pleasure that could otherwise accompany the use of opioids or alcohol is neutralized, as well as the chemical reinforcement of their continual abuse.
Moreover, when a person uses naltrexone over a prolonged period, they are actually teaching your brain that alcohol and opioids are no longer inducing pleasure or reward. This, in turn, helps to mitigate cravings and can prevent a relapse.
Who Can Prescribe Naltrexone?
Certain licensed health providers can prescribe naltrexone, and those who do vary by state. These might include doctors, psychiatrists, nurse practitioners, physician assistants, and psychologists.
Although your primary care provider can prescribe this medication in many cases, it may be more beneficial to receive expert care from an addiction education specialist, such as a psychiatrist or a psychiatric nurse practitioner at a mental health institution or addiction clinic. Regardless of who prescribes it, naltrexone should only be taken under the direct supervision of a healthcare provider.
Naltrexone Side Effects
Common side effects of naltrexone include the following:
- Abdominal pain and cramps
- Joint and muscle pains
- Nausea and vomiting
- Sleep disturbances
Some individuals report having experienced suicidal thoughts while using naltrexone. Persons with a history of suicidal ideation may be at increased risk of this side effect. If you begin to feel depressed or hopeless while taking naltrexone, talk to your healthcare provider as soon as possible.
Allergic Reactions to Naltrexone
As with any new medication, some persons are at risk of having an allergic reaction to naltrexone, signs of which may include the following:
- Red bumps on the body
- Abdominal pain
- Nausea and vomiting
- Swollen throat or tongue
- Breathing difficulties
If you develop an allergic reaction, you are urged to seek medical attention immediately.
Long-Term Effects of Naltrexone Use
Excessive doses and long-term use of naltrexone can cause harm to the liver, especially when naltrexone is combined with alcohol. You should contact your healthcare provider if you are experiencing any of the following symptoms, any of which might indicate significant liver damage:
- Dark urine
- Excessive fatigue
- Light-colored bowel movements
- Lack of appetite
- Pain in the upper right portion of the abdomen that persists longer than several days
- Unusual bruising or bleeding
Naltrexone comes in the form of a tablet and as an intramuscular injection. You and your healthcare provider or addiction specialist can discuss which administration method might work best for you. Both forms will begin blocking the mu-opioid receptors in the brain shortly after the first dose. Most therapeutic courses of naltrexone are carried out for at least three months.
Tablet Form (ReVia)
Naltrexone as a tablet comes in 25 mg, 50 mg, and 100 mg doses. An initial dose of oral naltrexone is usually 50 mg per day, but this can range from 25-100 mg, depending on individual circumstances. Often, healthcare providers will prescribe an initial dose of 25 mg to test a patient’s tolerance of the medication’s side effects and ensure that they do not have an allergic reaction to it.
Sometimes healthcare providers will suggest administering a 380 mg once per month injections. This method can cause some discomfort and pain at the injection site.
That said, those who receive the shot do not have to remember to take a pill every day. You will, however, need to wear a warning bracelet because this form of the medication will make you unresponsive to opioid analgesia in the event of an emergency.
Naltrexone blocks the effects of opioid-containing drugs and medications, which include some cough and cold and antidiarrheal remedies and opioid analgesics.
Naltrexone can also cause withdrawal symptoms in those who are opioid-dependent. For this reason, a person should be detoxed from opioids for at least one week before taking the first dose.
Patients are urged to be honest with their healthcare provider about their most recent use to ensure a safe experience. Some clinicians may use a drug screen or skin test to confirm that an individual has detoxed before beginning naltrexone treatment.
Never use heroin after having recently used naltrexone. The medication lowers an individual’s tolerance to opioids, which increases the risk of overdosing on even just a tiny amount.
How Effective Is Naltrexone?
Naltrexone has been proven effective in several studies. Research has examined the effectiveness of naltrexone and in general, it has shown some success in helping control a person’s alcohol and opioid use. Based on a 2010 review, it appears to decrease excessive alcohol consumption and reduce drinking days in those who are alcohol-dependent.
A study from 2013 published in the Journal of the American Medical Association revealed that naltrexone can reduce alcohol use in those with comorbid post-traumatic stress disorder (PTSD) and alcohol dependence.
Getting Help for Opioid or Alcohol Addiction
Just Believe Recovery is a specialized addiction rehab center that offers state-of-the-art, individualized, comprehensive programs in various formats, including residential and outpatient treatment. Our approach includes several evidence-based and holistic services and activities, such as psychotherapy, counseling, group support, substance abuse education, health, and wellness education, aftercare planning, and more.
We are committed to providing each person we treat with the tools, resources, education, and support they need to achieve abstinence, maintain long-term sobriety, and foster the happy, healthy, and satisfying lives they deserve!