Naltrexone is a medication used in the comprehensive treatment of alcohol use disorder (AUD). It helps reduce alcohol cravings and diminishes the pleasurable sensations associated with drinking. The medication is one component of a broader treatment strategy, often alongside counseling and support programs, to aid individuals in managing their alcohol consumption.
How Naltrexone Modifies Alcohol’s Effects
Naltrexone works by interacting with the brain’s reward system, specifically by acting as an opioid receptor antagonist, primarily blocking mu-opioid receptors in the brain. When alcohol is consumed, it typically triggers the release of natural feel-good chemicals, like endorphins, which bind to these opioid receptors and contribute to the pleasurable effects of drinking. By blocking these receptors, naltrexone interferes with the brain’s ability to process these rewarding signals, reducing the satisfaction or “buzz” alcohol usually provides and making drinking less appealing. Naltrexone does not prevent intoxication or change how the body metabolizes alcohol. Individuals can still experience the physical and cognitive impairments of alcohol, but the reinforcing euphoric effects are blunted.
The Experience of Drinking on Naltrexone
When an individual consumes alcohol while taking naltrexone, the primary difference experienced is a significant reduction or absence of the typical pleasurable “high” or euphoria. The medication works to disconnect the rewarding sensation from alcohol consumption. This means that while someone can still become impaired and exhibit signs of intoxication like slurred speech or poor coordination, the desired feelings of relaxation or exhilaration associated with drinking are lessened.
Naltrexone does not induce an immediate, severe physical illness or adverse reaction when combined with alcohol, unlike other medications such as disulfiram. However, common side effects of naltrexone itself, such as nausea, headache, dizziness, or fatigue, might be experienced, and in some cases, these could be intensified by alcohol consumption. Due to the blunted pleasurable effects, there is a potential for individuals to attempt to consume more alcohol to achieve the familiar “buzz,” which can lead to higher levels of intoxication.
Alcohol’s Ongoing Impact
Despite naltrexone’s ability to reduce the pleasurable effects of alcohol, continued drinking while on the medication still carries the inherent risks associated with alcohol consumption. The medication does not protect the body from the physical damage alcohol can cause, such as liver damage, cardiovascular issues, or other organ system harm.
Drinking while undergoing naltrexone treatment can also undermine the therapeutic goals of the medication. Naltrexone is intended to help reduce overall alcohol intake and support recovery, but continued consumption can hinder progress toward these objectives. The lack of a “stop” signal, due to the absence of pleasurable feedback, could inadvertently lead to an individual drinking larger quantities, resulting in higher blood alcohol content and increased risk of alcohol poisoning or other acute harms. Continued alcohol use can also negatively impact mental health and disrupt the broader recovery process, including engagement with counseling or support groups.
Guidance After Drinking on Naltrexone
If an individual consumes alcohol while taking naltrexone, maintaining open communication with their healthcare provider is important. Do not stop naltrexone abruptly if alcohol is consumed, as it is designed for continuous use. Stopping without medical guidance can disrupt the treatment plan and reduce its effectiveness in managing cravings and consumption.
Naltrexone works best as part of a comprehensive treatment strategy that includes counseling and behavioral therapies. A lapse in drinking does not signify complete treatment failure, but an opportunity to re-engage with support systems and re-evaluate the treatment approach with a medical professional. Healthcare providers can offer guidance, adjust the treatment plan if needed, and reinforce strategies to support long-term recovery goals.