If you are trying to stay sober and are experiencing cravings for drugs or alcohol, you might have considered taking a medication to help. Or maybe your doctor or treatment program has suggested medication. One common medication designed to deal with cravings for alcohol or opioids is called Naltrexone.
Medication Assisted Treatment for Opioid Use Disorder
Opioids include drugs such as heroin, morphine, codeine, and prescription pain medications such as Oxycontin, Oxycodone, and Norco. Opioid addiction rewires the brain. Because of this rewiring, substance use treatment alone is often not sufficient to address opioid addiction and medication is frequently also required. This combination of medication and treatment is called Medication Assisted Treatment, or MAT. MAT is considered the “standard of care” for opioid use disorder, meaning medical providers consider it to be the best approach to treatment, according to the CDC’s opioid use disorder treatment guidelines. Some patients also find medication helpful to deal with cravings for alcohol.
What is Naltrexone?
Naltrexone is an opioid antagonist — a medication that blocks opioid receptors in the brain. It is FDA-approved for the treatment of both alcohol and opioid use disorder, according to SAMHSA. It is taken in pill form. Vivitrol is a long-acting injectable version of this drug. Naltrexone and Vivitrol are not addictive and there are no withdrawal symptoms when you stop taking them.
How Does Naltrexone Work?
Naltrexone helps reduce cravings for opioids and alcohol by binding to and blocking opioid receptors in the brain. It also blocks the “high” and sedating effects of opioids. Research shows it is most effective when used in combination with substance use treatment, and its applications continue to expand beyond opioid addiction, as outlined in this NIH review of naltrexone’s uses.
When Can You Take Naltrexone?
Generally, a patient needs to wait at least 7–14 days after their last use of opioids before starting Naltrexone. A doctor can advise you on the specific waiting time for your situation. Someone who is still dependent on opioids or going through withdrawal should not take Naltrexone. Those with alcohol use disorder should also wait until they are no longer going through alcohol withdrawal before starting the medication. If you are interested in Naltrexone, the first step is to talk to your doctor to find out if you are a candidate and when it is safe to begin. While taking Naltrexone, a patient should be monitored by a physician. It is also very important not to take any other narcotics while on this drug. Consult a physician to find out which other medications to avoid.
Naltrexone for Alcohol Use Disorder
Naltrexone for alcohol use disorder is best suited for patients with moderate to severe alcohol use — someone who experiences alcohol-related problems, drinks on more than fifty percent of their days, and has more than five drinks on those days. This person has made past attempts to stop drinking without success and is motivated to abstain from alcohol. Research published on NIH’s PMC confirms naltrexone’s effectiveness in managing alcohol dependence as part of a broader treatment plan.
Support Options
A person who is taking a medication like Naltrexone to maintain sobriety and is avoiding drugs and alcohol is considered sober. In some instances, they may face stigma or pushback at 12-step meetings like Alcoholics Anonymous or Narcotics Anonymous for being on medication. However, there are also many AA and NA meetings where someone on MAT is welcome. Some people on MAT prefer meetings specifically designed for those in medication-assisted recovery. MARA — Medication Assisted Recovery Anonymous — offers meetings for these individuals. There are not as many MARA meetings as AA or NA meetings, so they can be trickier to locate, but you can find a MARA meeting near you on their website.
