Naltrexone Treatment for Alcohol and Opioid Addiction   

Making Naltrexone a Part of Your Addiction Treatment Plan

Addiction treatment professionals understand that medication alone isn’t enough for long-term recovery. Long-term recovery requires a comprehensive approach that combines medication-assisted treatment (MAT) with behavioral therapy.

If you’re taking naltrexone, it’s a great idea to do so alongside addiction counseling to increase your chances of successful treatment outcomes. Therapists can help you understand the underlying causes of your addiction and develop healthy coping strategies to manage cravings and work through difficult emotions. CBT is one behavioral therapy that’s commonly used in addiction treatment. It teaches you how to identify and challenge negative thought patterns that trigger cravings, and develop practical skills for managing stress. Learning to manage cravings goes a long way toward preventing relapse—tools like CBT can support your recovery for years to come. 

Considering Naltrexone as a Viable Option: Benefits, Risks, and Controversies

Benefits 

Naltrexone offers clear benefits when used as part of a comprehensive treatment plan, as it effectively reduces alcohol cravings and prevents relapse during and after treatment. Studies show that “subjects treated with naltrexone experience significantly fewer episodes of relapse, and significantly more remain abstinent” than people who don’t, and that “naltrexone-treated subjects also consume significantly less alcohol.”⁹ 

It’s also proven effective for those in opioid addiction recovery. One study found that “long-acting injectable naltrexone protected against relapse¹⁰ after discharge from short-term inpatient treatment” among patients with opioid addiction.

However, like other forms of MAT, naltrexone carries some risks. 

Potential Risks

The most common side effects of naltrexone¹¹ are nausea and vomiting. There is some concern about the drug increasing risks of liver or cardiovascular damage in this already vulnerable population. But most studies conclude that these risks are relatively low, especially compared with its benefits.

Starting naltrexone while you’re still physically dependent on opioids will trigger withdrawal symptoms. It’s critical to complete detox under medical supervision before starting naltrexone therapy. Proper medical oversight can help mitigate other potential side effects like nausea, headaches, and fatigue, which are usually mild and temporary.

One meta-analysis of several studies found that while naltrexone reduces relapse rates¹² in the short term, it did not increase retention rates in addiction treatment, and found no clear evidence that it supports sobriety over the long term.  

“Our alcoholism takes over.”

There’s always a chance that MAT won’t work as intended. One man in alcohol recovery, Wayne, was prescribed naltrexone as part of his addiction counseling program. Even though he said it took away the pleasurable effects of drinking, he was still determined to drink on naltrexone:¹³ 

I didn’t exactly intend on drinking over naltrexone but my alcoholic mind—the rewiring of my brain—said, ‘You could get over this one too; this doesn’t have to be your game stopper.’ So I had to drink double the amount, and I had to drink almost all the time, in order to still get that feeling that I had before. A lot of us are in the same boat: our alcoholism takes over and we challenge ourselves to get drunker and drunker.

Naltrexone has its drawbacks, and it’s not for everyone. But when used appropriately as part of a comprehensive recovery plan under medical supervision, it can be a valuable asset for those fighting addiction. 

Regulations and Drug Safety 

Naltrexone has undergone extensive testing and evaluation to ensure its safety and efficacy. 

Naltrexone is a longer-acting version of naloxone,¹⁴ which has been used since 1971 for reversing opioid overdoses in a medical emergency setting. It was approved by the FDA in 1984 for treating heroin addiction. In 2006, the naltrexone injections, branded as Vivitrol, were approved for alcohol dependence, and later used to treat opioid dependence. 

Any healthcare provider who is licensed to prescribe medications can prescribe naltrexone. Specialized training is not required. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides free training¹⁵ and mentoring to clinicians to identify and treat opioid use disorder. 

Naltrexone Therapy: One of Many Tools on Your Path to Recovery

Naltrexone therapy can be an effective tool for treating addiction. By reducing cravings and blocking the pleasurable effects of substances, it can significantly increase the chances of long-term recovery. 

Naltrexone’s non-addictive approach to relapse prevention is a stepping stone for many on their journey toward recovery. But it’s important to remember that naltrexone is most effective when integrated into a comprehensive treatment plan. Through therapy, you’ll address unresolved trauma and other underlying causes of addiction, and learn skills for life in sobriety. This holistic approach empowers you to manage cravings, make healthier choices, and take back control of your life.

If you’re struggling with addiction, don’t hesitate to seek out the care you need. Talk to your doctor or therapist, or use our addiction treatment finder to search for programs that fit your needs. 

You deserve to live a full, free life—and that change can start now.