Naltrexone is a medication approved by the U.S. Food and Drug Administration (FDA) for specific medical applications. It functions as an opioid antagonist, meaning it blocks the effects of opioids in the body. This medication is available in both an oral tablet form and an extended-release injectable formulation. It does not lead to addiction or a “high,” differentiating it from many other substances.
Understanding Naltrexone’s Purpose
Naltrexone is prescribed primarily to assist individuals managing alcohol dependence and opioid use disorder. For alcohol dependence, it works by reducing cravings and the rewarding effects associated with alcohol consumption, which helps to lessen the desire to drink.
In the context of opioid use disorder, naltrexone blocks the euphoric effects of opioids, which helps to reduce the motivation for misuse and can aid in maintaining abstinence after detoxification. It is often part of a comprehensive treatment plan that includes counseling and support.
Naltrexone’s Regulatory Status
Naltrexone is a prescription-only medication, meaning it cannot be obtained without authorization from a licensed healthcare provider. The U.S. Drug Enforcement Administration (DEA) does not classify naltrexone as a controlled substance. This classification is based on the finding that naltrexone does not have a potential for abuse or dependence, unlike substances such as opioids or benzodiazepines which are scheduled under the Controlled Substances Act (CSA).
The DEA explicitly removed naltrexone and its salts from control under the CSA. This distinction means that while its use is medically supervised, it is not subject to the same stringent regulations as substances categorized in Schedules I-V by the DEA. Any qualified medical doctor can prescribe naltrexone without special training or licenses typically required for controlled substances.
How Naltrexone Functions
Naltrexone primarily acts as an opioid receptor antagonist, specifically binding to mu-opioid receptors in the brain. By occupying these receptors, it prevents external opioids, such as heroin or prescription pain relievers, from attaching and producing their effects. This competitive blocking action eliminates the euphoric and rewarding sensations typically associated with opioid use.
In alcohol dependence, naltrexone’s mechanism involves blocking the effects of endogenous opioids, which are naturally produced by the body. Alcohol consumption can stimulate the release of these endogenous opioids, contributing to the rewarding aspects of drinking. By blocking these effects, naltrexone can diminish the pleasurable feelings from alcohol, thereby reducing cravings and consumption.
Obtaining Naltrexone
The process typically begins with a thorough medical evaluation to determine if the medication is appropriate. This evaluation often includes assessing liver function, as naltrexone can affect the liver, and confirming opioid-free status for at least 7 to 10 days before starting treatment for opioid use disorder to avoid precipitating withdrawal symptoms.
After a prescription is issued, the medication can be filled at a pharmacy, or through online pharmacies if the provider sends the prescription directly. Ongoing medical supervision is common, with follow-up appointments to monitor progress and address any concerns.