Naltrexone is a medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). It is available as an oral tablet taken daily or an extended-release injectable administered once a month. This medication helps individuals reduce cravings and the pleasurable sensations associated with alcohol or opioid use.
How Naltrexone Influences Alcohol Effects
Naltrexone functions as an opioid receptor antagonist, binding to mu-opioid receptors in the brain. When alcohol is consumed, the brain releases natural opioids called endorphins, which activate these opioid receptors. This activation contributes to the rewarding and euphoric feelings associated with drinking.
By attaching to these mu-opioid receptors, naltrexone blocks endorphins from binding, interfering with the brain’s reward pathways. This action reduces the pleasurable “buzz” or euphoria alcohol produces, making drinking less reinforcing. The medication aims to diminish the desire to continue drinking by breaking the learned connection between alcohol and pleasure.
What Happens When Drinking on Naltrexone
It is possible to still experience the intoxicating effects of alcohol while taking naltrexone. Naltrexone does not alter how the body metabolizes alcohol, nor does it prevent alcohol’s direct impact on the central nervous system. Individuals can still exhibit signs of intoxication such as impaired coordination, slurred speech, and drowsiness.
The key difference is the reduced or absent pleasurable sensations. The “buzz” or euphoria associated with drinking is blocked. This blunted reward response makes alcohol less appealing and can help reduce the motivation to continue drinking heavily. The goal is to lessen the desire to consume more alcohol, rather than to prevent physical intoxication.
Risks of Combining Alcohol and Naltrexone
Despite the reduced pleasurable effects, continued alcohol consumption while on naltrexone carries dangers. Naltrexone does not protect against the physical impairments or health consequences of alcohol. Individuals can still suffer from reduced coordination, slower response times, and impaired judgment, making activities like driving unsafe.
Heavy drinking while on naltrexone can lead to serious health complications, including alcohol poisoning and liver damage. While naltrexone itself has a mild impact on the liver at prescribed doses, excessive alcohol intake places a substantial burden on this organ. Naltrexone serves as a tool to support recovery by reducing cravings, but it is not a “cure” that permits safe, unrestricted drinking. Some individuals might attempt to drink more to try and achieve the previously experienced pleasurable effects, which can increase the risk of alcohol-related harm.
Importance of Professional Guidance
Naltrexone should only be used under the guidance of a healthcare professional as part of a comprehensive treatment plan for alcohol use disorder. Adhering to the prescribed dosage and schedule is important for the medication’s effectiveness. Naltrexone is most effective when combined with other forms of support, such as therapy, counseling, and participation in support groups.
Patients should discuss any side effects or continued drinking patterns with their healthcare provider to ensure the treatment plan remains appropriate and effective. Consulting a medical professional provides personalized advice and helps manage the complexities of AUD recovery.