Naltrexone for Alcohol Use Disorder: How It Works and What To Expect

Naltrexone is an FDA-approved medication that can help some people with alcohol use disorder reduce drinking or maintain recovery. It is available as an oral medication or a longer-acting injection. It does not treat acute alcohol withdrawal, and it is not right for everyone.

What if cutting back on alcohol wasn’t just about willpower? 

Naltrexone takes a different approach by targeting the brain’s reward system, helping reduce the “feel-good” effects that can reinforce drinking. But how exactly does it work, and what should you know before considering it? 

Understanding how naltrexone works and its possible limitations is vital. In this guide, we’ll break down how naltrexone works for alcohol use, precautions to be aware of, and why it may be a valuable part of a broader treatment plan.

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Table of Contents

• How Does Naltrexone Work for Alcohol Use Disorder?
• 5 Precautions Concerning Naltrexone Use for Alcohol Addiction Recovery
• Frequently Asked Questions About Naltrexone in Treating Alcohol Use Disorder
• Robin Recovery Offers Medication as Part of a Holistic Approach to Recovery

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How Does Naltrexone Work for Alcohol Use Disorder?

Naltrexone is a prescription medication designed to help people overcome alcohol use disorder (AUD) or opioid use disorder. 

In alcohol use disorder, naltrexone works by blocking opioid receptors in the brain by:

• Blocking endorphins, the feel-good chemicals released in the brain
• Removing the reward by acting as a blocker to stop endorphins from activating the brain's reward pathway
• Dulling the urge to drink by making drinking feel less satisfying and easier to stop or cut back on over time

If you or a loved one is in need of compassionate alcohol addiction treatment in Columbus, Ohio, from professionals interested in seeing you succeed in your recovery, Robin Recovery is here to help. Our comprehensive alcohol addiction program focuses on the individual and may include medication management to support recovery when needed. Contact our admissions team for more information. 

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How Fast Does Naltrexone Work for Alcohol?

Naltrexone is available as tablets or a longer-acting injection. Your prescriber will explain the formulation, expected effects, and follow-up plan. The timing of changes in drinking or cravings varies.

Many individuals begin noticing a change in craving intensity within a week, while it may take a few weeks or even months for others. 

Treatment length is individualized and reviewed with the prescriber. Counseling and other recovery support may be included alongside medication.

How Well Does Naltrexone Work for Alcohol?

Research has found that, for a significant number of people, naltrexone is effective in reducing alcohol cravings. 

Benefits of naltrexone include:

• Fewer alcohol-related thoughts
• Less interest in drinking heavily or daily
• Reduced overall appeal 
• More rapid decrease in cravings
• Reduced reward sensitivity 
• Reduced risk of relapse

5 Precautions Concerning Naltrexone Use for Alcohol Addiction Recovery

#1: Be Aware of Possible Side Effects and Contraindications

While naltrexone is safe for the majority of people, it’s always a good idea to be aware of the possible side effects, which may include: 

• Sleepiness or trouble sleeping
• Nausea and vomiting
• Headache
• Dizziness 
• Decreased appetite 
• Painful joints or muscle cramps 
• Toothache 
• Common cold symptoms 

• Severe allergic reactions 
• Injection site reactions, such as swelling, tissue death, and lumps
• Liver damage or hepatitis 
• Depressed mood 
• Pneumonia 

Naltrexone is also contraindicated under the following conditions: 

• If you’re actively using opioids
• If you haven’t been opioid free for at least 10 days 
• If you have acute liver disease 
• If you’re allergic to any of the ingredients 
• If you anticipate needing opioid pain medications 

#2: Don’t Rely Only on Naltrexone

While naltrexone is a useful tool in helping manage alcohol cravings, it alone is not a cure for AUD. A holistic approach to recovery is vital for achieving full sobriety. 

Naltrexone should be paired with other alcohol treatment supports, such as: 

• Inpatient or outpatient programs
• Cognitive behavioral therapy
• Peer support groups 
• Lifestyle changes 
• Counseling 
• Family therapy 
• Consistent schedules 
• Nutritious meals 
• Journaling 
• Regular exercise 
• Time in nature 
• Fitness classes
• Meditation 

#3: Don’t Take Until After Alcohol Detox 

Starting naltrexone requires an assessment of alcohol withdrawal, recent opioid exposure, liver health, and the medication formulation. It does not treat acute alcohol withdrawal. Follow your prescriber’s plan rather than a universal waiting period.

Naltrexone can precipitate withdrawal in someone who is physically dependent on opioids. Tell your prescriber about all opioid medicines and substances, including buprenorphine and methadone, before treatment.

#4: Adjust Timeline for Recent Opioid Use

Your prescriber must determine a safe opioid-free interval before naltrexone. Do not stop prescribed opioid treatment or attempt withdrawal on your own to begin it.

Opioids must have time to leave your system before taking naltrexone, or you will trigger severe withdrawal symptoms. Recommended timeframes for taking naltrexone are seven to ten days after last use of short-acting opioids and 10 to 14 days after last use of long-acting opioids.

#5: Be Wary of Subsequent Opioid Vulnerability

Naltrexone has the potential to lower the body’s tolerance to opioids by blocking the brain’s opioid receptors, making your body lose its tolerance to the drug. Without tolerance, a dose of opioids an individual may have handled in the past can be highly toxic and result in: 

• Respiratory arrest
• Coma
• Death 

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Frequently Asked Questions About Naltrexone in Treating Alcohol Use Disorder

Is Naltrexone Addictive?

No. Since the reward pathways of the brain aren’t activated and the drug doesn’t cause feelings of euphoria or pleasure, naltrexone is not addictive.  

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What Will Happen if You Drink Alcohol While Taking Naltrexone?

If you drink alcohol while taking naltrexone, you may experience less of the pleasurable effects or “reward” from drinking. However, naltrexone does not prevent intoxication or eliminate alcohol’s risks, so it’s still important to drink cautiously and follow your healthcare provider’s advice.

When Should I Stop Taking Naltrexone?

There are no stringent guidelines for how long an individual should take naltrexone. Medical professionals work with patients to determine a timeline based on: 

• AUD severity
• Risk of relapse
• Tolerance of side effects 
• Personal goals 

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Robin Recovery Offers Medication as Part of a Holistic Approach to Recovery

At Robin Recovery, we care about seeing you succeed in your recovery journey. Our treatment programs are designed to meet you where you are and include:

• Intensive outpatient program
• Partial hospitalization program
• Outpatient program
• Counseling and therapy
• Detox
• Psychotherapy
• Medication management
• Peer support groups
• Other evidence-based therapies

Alcohol addiction is complex, and our team of professionals is committed to supporting you as you travel the road to recovery. If you or a loved one is struggling with alcohol use disorder, contact the team at Robin Recovery today. 

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Medication support and your next step

Robin Recovery provides medication management through addictionologists and psychiatric nurse practitioners for people at our Whitehall and Independence locations, serving Columbus and Cleveland. This can include medications for withdrawal symptoms and Suboxone when clinically appropriate. An assessment determines whether outpatient care is suitable or a higher level of care is needed.

Ask about insurance benefits or speak with admissions about available care. Verification does not guarantee coverage, payment, or admission.