Naltrexone is a medication used to treat Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD). It works by reducing cravings and diminishing the rewarding sensations associated with alcohol or opioid consumption. While naltrexone is a valuable tool in recovery, consuming alcohol while on this medication is generally not advised. This article explores the effects and potential risks of combining alcohol and naltrexone.
Understanding Naltrexone’s Action
Naltrexone acts as an opioid receptor antagonist, primarily by binding to mu-opioid receptors in the brain, where alcohol consumption triggers the release of endorphins, internal opioids that bind to these receptors, creating feelings of pleasure. Naltrexone blocks these receptors, preventing endorphins from binding and activating the brain’s reward pathways. This action reduces the pleasurable “buzz” or rewarding effects alcohol usually produces, making drinking less satisfying. While naltrexone lessens the desire for alcohol by interfering with its pleasurable effects, it does not prevent physical intoxication or impairment. Naltrexone is not addictive and does not cause withdrawal symptoms when discontinued, unless an individual is physically dependent on opioids.
The Immediate Effects of Combining Alcohol and Naltrexone
When alcohol is consumed while taking naltrexone, the most notable immediate effect is a significant reduction or absence of the typical euphoric “buzz.” This blunted reward response helps decrease the reinforcing pleasure of drinking. Despite diminished pleasurable feelings, the intoxicating effects of alcohol persist. Individuals will still experience impaired judgment, reduced coordination, slowed reaction time, and slurred speech. This can lead to a dangerous situation where a person might drink more than intended due to the lack of a pleasurable signal, without fully realizing their level of physical and mental impairment. Unlike some other medications for alcohol use disorder, naltrexone does not cause an individual to become violently ill if alcohol is consumed. However, common side effects of naltrexone, such as nausea, headache, dizziness, or fatigue, might be experienced or intensified when combined with alcohol.
Potential Risks of Drinking Alcohol While on Naltrexone
Consuming alcohol while on naltrexone presents several risks. One concern is the possibility of increased alcohol consumption. Because pleasurable effects are blocked, some individuals might drink more to achieve a desired “buzz,” increasing their risk of alcohol poisoning. This can lead to severe intoxication, accidents, and injuries due to impaired physical and cognitive function.
Liver health is another concern. Both alcohol and naltrexone are processed by the liver, and combining them can place additional strain on this organ. While naltrexone generally carries a low risk of liver damage at recommended doses, and continued heavy alcohol consumption poses a greater threat, individuals with pre-existing liver conditions should discuss this with their healthcare provider.
Drinking alcohol while taking naltrexone can also undermine the primary goals of AUD treatment. The medication helps reduce or stop alcohol consumption by altering the brain’s response. Continued alcohol consumption can hinder therapy progress and reinforce problematic drinking patterns, making long-term recovery more challenging. Other health risks associated with chronic alcohol abuse, such as cardiovascular issues, neurological damage, and digestive problems, remain if drinking continues.
Guidance for Individuals Taking Naltrexone
For individuals prescribed naltrexone, adhering to the medication regimen as directed by a healthcare provider is important. Do not discontinue naltrexone without consulting a doctor, even if alcohol is consumed. Naltrexone is most effective when taken consistently, as its benefits in reducing cravings and promoting less frequent or lighter drinking are enhanced with steady use.
Open and honest communication with a healthcare provider is also important. Discuss any alcohol consumption, persistent cravings, or experienced side effects, as this allows for adjustments to the treatment plan. If a “slip” occurs and alcohol is consumed, continuing naltrexone is generally advised, as it may help limit the severity of the relapse.
Naltrexone works best when integrated into a comprehensive treatment approach that includes counseling, behavioral therapy, or support groups. These interventions address the psychological and social aspects of AUD, providing coping strategies and support systems for sustained recovery. While some individuals may begin naltrexone while still drinking, a period of abstinence before starting the medication can sometimes help reduce side effects and promote better outcomes.