Naltrexone is an FDA-approved medication for alcohol use disorder that can reduce alcohol’s rewarding effects and help some people reduce heavy drinking or support abstinence. It is available as a daily oral tablet and as a monthly extended-release injection.
How does naltrexone work for alcohol use disorder?
Naltrexone blocks opioid receptors involved in the brain’s reward response. For some people, this reduces the reinforcing effects of alcohol and decreases the urge to drink.
Does someone have to stop drinking before starting naltrexone?
Unlike disulfiram or acamprosate, oral naltrexone can sometimes be started while a person is still drinking, depending on clinical assessment. However, a clinician should evaluate liver health, opioid use, medications, and treatment goals first.
Why does opioid use matter?
Naltrexone blocks opioids. Someone who is physically dependent on opioids must complete an opioid-free period before starting it or severe precipitated withdrawal can occur. It also interferes with opioid pain medicines.
What is the difference between oral and injectable naltrexone?
Oral naltrexone is taken regularly by mouth. Extended-release injectable naltrexone is given about monthly, which can help with adherence. Trinity’s guide to extended-release injectable naltrexone explains that formulation in more detail.
Is naltrexone addictive?
No. It is not an opioid agonist, is not a controlled substance, and does not produce alcohol-like intoxication.
Can naltrexone be combined with counseling?
Yes. Medication can be combined with behavioral therapy, recovery support, and treatment for co-occurring mental health conditions.
See Trinity’s overview of medications for alcohol use disorder. This article does not state that Trinity currently prescribes naltrexone; availability should be verified directly.
Frequently asked questions
Does naltrexone make you sick if you drink?
No. That is the mechanism associated with disulfiram, not naltrexone.
Can naltrexone reduce cravings?
Yes, it can reduce craving and alcohol reward for some patients.
Can someone take naltrexone if they use opioids?
Not while physically dependent on opioids. A clinician must evaluate the required opioid-free interval.
Sources
This article is general education and does not replace individualized medical advice.