Naltrexone for Alcohol Use Disorder

Alcohol dependence, also known as Alcohol Use Disorder (AUD), is a chronic condition affecting millions. It involves physical, mental, and social factors, leading to an inability to control or stop drinking despite negative consequences.

Overcoming AUD is challenging due to physical and psychological dependence, social pressures, and the risk of relapse.

Fortunately, naltrexone is an effective tool when incorporated into a comprehensive treatment. Let’s explore how it helps manage AUD, its benefits, and other important considerations.

What is Naltrexone?

Naltrexone is a prescription medication that’s powerful in overcoming alcoholism. Its effectiveness comes from its ability to target the very root of the problem⁠—the intense desire to drink.

Studies have shown that naltrexone can not only decrease heavy drinking episodes but also prevent relapse if a person does slip. Maintaining sobriety after treatment is a crucial aspect of recovery from alcoholism.

Naltrexone plays a significant role in this process by tackling two critical triggers for relapse: cravings and the pleasurable effects of alcohol. By reducing both, naltrexone helps people stay on track with their recovery goals.

How Does Naltrexone Work on Alcoholism?

Naltrexone works by interfering with the brain’s pleasure response to alcohol. By blocking specific receptors, it disrupts the release of dopamine, a neurotransmitter associated with feelings of reward.

This diminished reward makes drinking less enjoyable, ultimately reducing the urge to consume alcohol. It can be used daily or as needed, with both approaches proving effective in reducing binge drinking.

Different Forms of Naltrexone

Naltrexone is available in two forms. Both forms are effective in reducing alcohol cravings and are often used as part of a comprehensive treatment plan that includes behavioral therapies and support groups.

Oral Tablets

The oral form of naltrexone is typically taken once daily. The standard dosage is 50 mg per day, but the dosage can be adjusted based on your needs and tolerance.

This form is convenient for daily use and allows for flexible dosing schedules, such as taking the medication every other day or adjusting the dose to avoid side effects.

Injectable (Vivitrol)

The extended-release injectable form, known as Vivitrol, is administered as an intramuscular injection once a month.

This form is beneficial for those who may have difficulty adhering to a daily medication regimen, as it ensures consistent medication levels in the body over a longer period.

The standard dose for the injectable form is 380 mg, administered every four weeks. 

Injectable vs. Oral Naltrexone

Here’s a quick comparison between injectable (vivitrol) and oral naltrexone.

The injectable form of naltrexone, Vivitrol, might be preferable to the oral formulation. Still, talking to your doctor is important to find the right fit.

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Potential Side Effects and Considerations for Naltrexone

Naltrexone is generally considered safe and well-tolerated when used as prescribed for the treatment of alcohol use disorder (AUD). Like all medications, naltrexone can cause side effects and has certain contraindications that need to be considered.

The most common side effects of naltrexone include:

• Nausea and vomiting: These are the most frequently reported side effects and often occur when starting the medication.
• Headache: Many people experience headaches, which can vary in intensity.
• Dizziness and drowsiness: These symptoms can affect daily activities and are important to monitor, especially when driving or operating machinery.
• Fatigue and tiredness: Some people may feel fatigued while taking naltrexone.
• Sleep problems: Insomnia or other sleep disturbances are also common.
• Joint and muscle pain: You may experience aches and pains in your muscles and joints.
• Loss of appetite: A decreased appetite can sometimes lead to weight loss.

Serious Side Effects of Naltrexone

While serious side effects are less common, they can occur and require immediate medical attention.

Liver damage is a known serious side effect. Symptoms include:

• Severe abdominal pain
• Dark urine
• Jaundice (yellowing of the skin or eyes)
• Unusual fatigue

Another side effect is having severe allergic reactions. Signs include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

Mood changes, including depression and suicidal ideation, have also been reported and should be closely monitored.

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Naltrexone in a Comprehensive Treatment Plan

Naltrexone is a powerful medication that can help you fight cravings and stay on track with your recovery from alcohol use disorder (AUD). However, it works best when combined with other forms of support, like counseling and support groups.

Naltrexone alone can help, but adding therapy can make it even more effective. It can help you manage cravings and other aspects of AUD that the medication can’t address on its own.

Tips for Successful Recovery Using Naltrexone

Here are some ways to maximize the benefits of naltrexone in your recovery journey:

• Stay connected: Regular check-ins with healthcare providers and participating in support groups keep you accountable and provide a support system.
• Tech tools: Phone reminders and self-monitoring apps can help you remember to take your medication and track your progress.
• Manage side effects: Starting with a lower dose and talking to your doctor can help ease side effects like nausea, making it easier to stick with treatment.
• Knowledge is power: Learning about naltrexone, its potential side effects, and the benefits of combining it with other treatments can keep you motivated.
• Personalized plan: A treatment plan that fits your needs and preferences is more likely to be successful. Talk to your doctor about what works best for you.

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