Naltrexone For Alcoholism Treatment
Naltrexone is a form of prescription medication that is used to treat alcohol addiction. It can be a helpful part of a recovery plan if medicated and taken properly.
Naltrexone does not treat alcohol or drug withdrawal symptoms. However, it can help individuals who have already stopped using drugs or alcohol to remain drug or alcohol-free.
Naltrexone was initially used to help treat addictions to opioids and heroin. Once taking Naltrexone, individuals found that they no longer experience the ‘high’ and pleasure sensation usually associated with and experienced after taking the drug.
As a consequence, they become less motivated to use the addictive substance in the future.
It soon became apparent that the same was true for alcoholics and Naltrexone.
How does Naltrexone Work?
Once alcohol enters the body, it quickly enters the bloodstream and releases feel-good chemicals called endorphins that give the individual a sense of ‘high.’
It is only available for those who have already stopped drinking and works by reducing the craving for alcohol that many people who have quit alcohol still experience [1].
Naltrexone works by blocking the receptors in the brain that produce the feeling of being ‘high’ when you drink alcohol.
It’s able to do so as it’s a class of drugs known as opiate antagonists. This means that it’s able to compete with other drugs for the receptors in the brain in order to prevent the pleasure feeling that abusive substances produce [2].
Over time, the brain will begin to disassociate alcohol with happiness. Even if the individual relapses, Naltrexone will prevent them from ever achieving the same relaxed, happy or ‘high’ that they once experienced from alcohol.
It’s imperative that the individual is no longer physically dependent on alcohol or any other substances as they will experience strong side effects from taking the medication.
It’s due to these uncomfortable symptoms that health and medical care providers typically wait until after the detox process is complete before suggesting the use of Naltrexone. They usually wait approximately 10 days afterwards [2].
Many other forms of medications used to help alcohol addictions are addictive themselves. Unlike other forms of medication, Naltrexone is non-addictive and non-narcotic.
Thanks to this, users will not develop other forms of addiction or dependence on the medication, unlike with so many other medications for alcohol and drug dependencies.
Proper Use of Naltrexone
As with most other medications, Naltrexone is prescribed and should only be taken under the careful supervision of a medical professional.
It should only be prescribed after the individual has already given up alcohol completely and has finished their detox programme.
Due to its possible side effects, Naltrexone should only be prescribed when you are sure the liver of the individual is now functioning properly and has recovered from fatty liver disease.
It’s also important to be sure that the individual is not pregnant before taking Naltrexone [2].
Side Effects of Naltrexone
There is a list of side effects associated with Naltrexone that individuals should be aware of before starting to take the medication.
Most side effects are mild and may only last just a few days. However, some can be more serious which is why it’s imperative that the individual has abstained from taking alcohol and the liver has fully recovered.
Having alcohol in your system can dramatically worsen the side effects which may lead to further complications down the line.
Here is a list of some common side effects usually associated with taking Naltrexone [3]:
- Feeling nauseous
- Being sick
- Stomach cramping
- Muscle or joint ache and pain
- Difficulty sleeping at night
- Headaches and migraines
- Feeling anxious or restless
Here is a list of some rare, but serious side effects of taking Naltrexone [3]:
- Hallucinations or confusion
- Feeling short of breath
- Blurred vision
- Skin rash
- Hearing a ringing in the ears
- Diarrhea
- Swelling in the feet, legs or face
- Feelings of depression
You should contact your doctor immediately if you do experience any of the above, rare symptoms. If these symptoms go unnoticed, Naltrexone can potentially cause liver toxicity.
You should stop taking Naltrexone immediately if you begin to experience any of the following symptoms:
- Unusual bleeding or bruising anywhere on the body
- Yellowing of the skin or eyes
- Dark or off colour urine
- Stomach pain (specifically in the upper right part of the stomach)
How does Naltrexone Impact Your Mood?
As Naltrexone blocks your receptors and stops you from feeling the endorphins alcohol releases, some people have questioned if the drug also prevents healthy endorphins from being released: endorphins that impact and maintain your mood.
However, it’s important to understand that the current evidence suggests that Naltrexone only affects the endorphins released by drugs and alcohol.
One theory is because alcohol elevates hormones in a very particular way which activates the gabaergic system, whilst other behaviours do not. As a result, Naltrexone only seems to target the endorphins created by drinking alcohol or taking drugs [4].
To conclude, individuals do not lose pleasure from other, pleasant activities whilst taking Naltrexone. However, it’s normal for an individual to report emotional changes whilst taking the medication. If this occurs, you can always discuss your worries with your doctor.
Forms of Naltrexone Medication
If you’re considering approaching your doctor or health care professional for more information on Naltrexone, then it’s important to understand the different forms of the medication.
There are three main forms of Naltrexone (tablet, injectable and the implant) and each have their own benefits.
1. Naltrexone in Tablet Form
Naltrexone often comes in tablet form and is often used in an inpatient, rehab setting.
There are two main tablets Naltrexone brand names (ReVia and Depade) and tablets are generally taken once per day.
It’s crucial that the pill is taken every day and is never missed. If a dose is missed or if an individual takes more than one pill a day (or more than is prescribed) then this may cause serious health complications.
However, it’s often difficult to remember to take the pill at the same time every day.
2. Injectable Naltrexone
Injectable Naltrexone is very popular with outpatient rehab centres.
The injectable form of Naltrexone is usually sold under the brand name Vivitrol and is injected into the muscle of the individual once a month.
As a result of the injection, patients may suffer some pain, swelling, redness or tenderness in the injected area. This can last for a few days after the injection each and every month.
If you are unable to consistently take the Naltrexone in pill form on a daily basis, then injectable Naltrexone is a good alternative.
However, just as with the pill form, injectable Naltrexone must also be taken on a strict and consistent schedule – every four weeks.
3. Naltrexone Implant
Implants are a relatively new way of administering Naltrexone and are now frequently being used in rehab centres and clinics.
They are administered by inserting a small implant under the patient’s skin, which slowly releases the medication into the bloodstream for 2 months / 8 weeks at a time.
Implants are a very convenient way to receive Naltrexone as it doesn’t require daily or weekly medical attention or checkups. Therefore, it’s an ideal solution for outpatients.
However, unfortunately, as it’s still relatively new, some insurance providers do not cover the costs of the Naltrexone implant. Therefore you should check with your doctor or medical professional before deciding on this form of Naltrexone.
If you’ve recently finished the detox process and are recovering from an addiction to alcohol, then you may still be experiencing cravings for alcohol.
If this is the case, then you should approach your doctor for more information on Naltrexone.
References
[1] Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733
[2] Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues Clin Neurosci. 2007;9(4):455-70. PMID:18286804
[3] Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2009. (Treatment Improvement Protocol (TIP) Series, No. 49.) Chapter 4—Oral Naltrexone.
