Naltrexone is a medication approved by the U.S. Food and Drug Administration (FDA) to help individuals manage alcohol use disorder (AUD). It assists in reducing alcohol consumption and maintaining abstinence. This medication is a tool used as part of a broader treatment approach for AUD, not a cure.
How Naltrexone Works
Naltrexone functions as an opioid receptor antagonist. Alcohol consumption stimulates the release of endogenous opioids, which bind to these receptors and contribute to alcohol’s rewarding effects. By blocking these receptors, naltrexone reduces the pleasurable feelings associated with drinking, decreasing alcohol cravings and the motivation to drink. The medication does not produce opioid-like effects and is not addictive. It aids individuals in reducing alcohol intake or maintaining sobriety by making alcohol ingestion less pleasurable.
Understanding Dosage and Administration
For alcohol use disorder, the typical oral dosage of naltrexone is 50 milligrams (mg) taken once daily. A 100 mg daily dose is not typically prescribed for AUD. While higher doses, such as 100 mg every other day or 150 mg every three days, have been explored for other conditions like opioid use disorder, they are not generally recommended for AUD. In some supervised settings, a daily dose exceeding 50 mg might be administered.
Naltrexone is available as an oral tablet and an extended-release injectable suspension. Oral tablets are taken once a day. The injectable form, marketed as Vivitrol, is a 380 mg intramuscular injection administered once a month by a healthcare provider. This option offers convenience, benefiting individuals who struggle with consistent daily medication adherence.
Potential Side Effects and Important Considerations
Naltrexone can cause side effects, though it is generally well-tolerated by most individuals. Common side effects include nausea, vomiting, headache, dizziness, and changes in sleep patterns. For the injectable form, reactions at the injection site such as redness, itching, or swelling may occur. These mild effects often improve over time.
More serious, but less common, side effects can occur. Naltrexone may rarely cause liver damage and is contraindicated in individuals with acute hepatitis or liver failure. Symptoms of liver issues, such as dark urine, yellowing of the skin or eyes, or stomach pain, should prompt immediate medical attention. Individuals who are currently using opioids or are experiencing opioid withdrawal symptoms should not take naltrexone, as it can precipitate severe withdrawal. It is important to discuss all medications, including over-the-counter drugs and herbal supplements, with a healthcare provider before starting naltrexone.
Naltrexone’s Role in a Comprehensive Treatment Plan
Naltrexone is most effective when integrated into a comprehensive treatment strategy for alcohol use disorder. This medication is not a standalone cure and works best when combined with other therapeutic interventions.
Behavioral therapies, such as Cognitive Behavioral Therapy (CBT), and individual or group counseling sessions, can provide individuals with coping mechanisms and strategies for managing triggers and cravings. Participation in support groups, such as mutual-help groups, also contributes to long-term recovery.
The medication serves as a tool to help reduce the desire to drink and prevent relapse, while counseling and support address the underlying psychological and social aspects of alcohol use disorder. This combined approach supports individuals in achieving and maintaining recovery goals.