Naltrexone is a medication used to support recovery from substance use disorders. It works in the brain to manage cravings and reduce the rewarding effects of certain substances. Because of its specific mechanism of action and the conditions it treats, its use requires careful medical guidance and professional oversight. Understanding how to access this treatment involves knowing its regulatory status and the necessary professional supervision.
Naltrexone is Prescription Only
Naltrexone is classified as a prescription-only medication and cannot be purchased over-the-counter. A licensed healthcare provider must authorize its use due to the need for patient screening and ongoing monitoring. Regulatory requirements ensure the drug is administered safely, especially considering its potent effects on the body’s opioid receptors.
The medication is distinctly different from controlled substances, such as most prescription opioids, which are regulated because of their potential for misuse and physical dependence. Naltrexone is not a narcotic, does not cause euphoria, and has no potential for addiction. Despite its non-controlled status, the drug’s powerful action mandates professional medical oversight to prevent adverse effects and ensure treatment suitability.
Primary Medical Applications
The U.S. Food and Drug Administration (FDA) has approved Naltrexone for the treatment of two primary conditions: Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD). It functions as an opioid receptor antagonist, meaning it binds to and blocks opioid receptors in the brain, particularly the mu-opioid receptor. This action prevents alcohol or opioids from activating the brain’s reward pathways, thereby reducing cravings and the pleasurable effects associated with their use.
For individuals with AUD, Naltrexone works by blocking the effects of endorphins, which the body releases when alcohol is consumed. By interrupting this process, the medication reduces the reinforcement that drives continued heavy drinking. This reduction helps patients lessen their consumption and reduces the likelihood of relapse.
The use of Naltrexone for OUD requires a crucial safety step: the patient must be completely detoxified from opioids before starting the medication. If Naltrexone is taken while opioids are still in a person’s system, it can trigger a sudden and severe withdrawal reaction. Healthcare providers typically recommend a period of at least seven to ten days of abstinence from short-acting opioids before initiating treatment. This mandatory waiting period is a primary reason the medication requires strict medical supervision.
Oral Tablet Versus Extended-Release Injection
Naltrexone is available in two main formulations, giving patients and providers flexibility in treatment planning.
Oral Tablet
The first is a daily oral tablet, typically dosed at 50 milligrams. This formulation offers convenience and the ability to stop the medication quickly if necessary. It is commonly prescribed for AUD and may be used for OUD, though adherence can sometimes be a challenge. The tablet can be picked up at a pharmacy and taken at home.
Extended-Release Injection
The second formulation is an extended-release, injectable suspension, often referred to by the brand name Vivitrol. This version is a 380-milligram intramuscular injection administered once every four weeks. The extended-release formulation slowly releases the medication over a month, circumventing the need for daily dosing and potentially improving adherence. The injection must be administered in a healthcare setting by a medical professional.
The choice between the two forms is often based on patient preference, the specific disorder being treated, and concerns regarding treatment adherence. Studies suggest the injectable form may lead to higher retention rates in treatment for OUD.
Steps for Obtaining a Prescription
Obtaining a prescription for Naltrexone begins with a consultation with a licensed healthcare provider. Any doctor authorized to write prescriptions can prescribe Naltrexone, including primary care physicians, psychiatrists, and addiction specialists. Telehealth platforms have also become a common pathway to connect with a qualified clinician for an initial assessment.
During the medical consultation, the provider will conduct a thorough review of the patient’s medical history, current medications, and substance use patterns. This step is necessary for determining the appropriateness of the drug and ruling out potential contraindications, such as liver impairment. The provider will also discuss the goal of treatment, whether it is to reduce heavy drinking or to prevent relapse to opioid use.
If the provider determines Naltrexone is suitable, they will issue the prescription. This can be sent electronically to a pharmacy for the oral tablets. If the extended-release injection is chosen, the patient will coordinate with their provider’s office to schedule the monthly administration. Ongoing monitoring is necessary to ensure the medication is effective and that any potential side effects are managed by the care team.