Naltrexone is a prescription-only medication, not available over-the-counter. Approved by the Food and Drug Administration (FDA), it is used for specific medical conditions and requires proper medical oversight to ensure both safety and effectiveness.
What is Naltrexone?
Naltrexone is an opioid antagonist that blocks opioid receptors in the brain. This prevents opioids from binding, which reduces cravings and diminishes their euphoric or sedative effects.
It is FDA-approved for treating alcohol use disorder (AUD) and opioid use disorder (OUD). For AUD, naltrexone can decrease alcohol consumption by making drinking less pleasurable. For OUD, it blocks opioid effects and reduces cravings.
Why Naltrexone Requires a Prescription
Naltrexone requires a prescription due to important safety and medical considerations. A significant reason is the potential for precipitated opioid withdrawal if taken while opioids are still in a person’s system. This can lead to severe and immediate withdrawal symptoms, making a thorough medical evaluation essential before starting treatment.
Healthcare providers must confirm that an individual is opioid-free for a minimum of 7 to 10 days before initiating naltrexone to avoid this adverse reaction.
The medication can also cause side effects, some of which require medical management. Common side effects include nausea, headache, dizziness, and stomach pain. More serious, though less common, side effects can involve liver injury, with symptoms like dark urine, yellowing skin or eyes, or unusual fatigue. Medical supervision ensures that these side effects are appropriately managed and that liver function is monitored, especially for individuals with pre-existing liver conditions.
Naltrexone’s dosage needs careful determination, as it can vary based on individual health conditions and treatment goals. A healthcare professional assesses a patient’s medical history, including any co-occurring conditions or other medications, to tailor the treatment plan. This personalized oversight minimizes risks and optimizes the medication’s effectiveness within a comprehensive treatment approach.
How to Obtain Naltrexone
To obtain naltrexone, an individual must first consult a healthcare provider. This can include a primary care physician, psychiatrist, or addiction specialist. During this consultation, the provider conducts a thorough medical assessment, which typically involves evaluating the patient’s medical history, current substance use, and overall health to determine if naltrexone is an appropriate and safe treatment option. A diagnosis for alcohol use disorder or opioid use disorder is generally required, as naltrexone is specifically approved for these conditions.
Once deemed suitable, the healthcare provider issues a prescription. Naltrexone is available in two main forms: an oral tablet (e.g., ReVia), typically taken daily at 50 mg, and an extended-release injectable formulation (Vivitrol), administered intramuscularly by a healthcare professional once a month, usually at a dose of 380 mg. Both forms have demonstrated efficacy in reducing cravings and supporting recovery, with the choice often depending on patient preference and adherence considerations. Online consultations are also available through various telehealth services, allowing patients to be assessed and receive a prescription from their home.
Important Considerations for Naltrexone Use
Once prescribed, consistent adherence to the naltrexone regimen is important for successful outcomes. Naltrexone is most effective when used as part of a comprehensive treatment plan that often includes counseling, therapy, or support groups. It is not a cure for addiction but rather a tool to help manage cravings and reduce the likelihood of relapse.
Individuals taking naltrexone should be aware of potential side effects, such as nausea, headache, dizziness, or difficulty sleeping. While these are often mild and may lessen over time, any persistent or severe symptoms, particularly signs of liver problems like yellowing skin or dark urine, should be reported to a healthcare provider immediately. Ongoing medical monitoring, including liver function tests, may be necessary during treatment.
It is also crucial to avoid using opioids while on naltrexone, as the medication blocks their effects and can increase the risk of overdose if an individual attempts to overcome the blockade by taking larger amounts of opioids. Patients should inform all healthcare providers, including dentists, about their naltrexone use, especially before any procedures requiring pain medication, as opioid analgesics will be ineffective.