Naltrexone medication plays a powerful role in addiction treatment. The Food and Drug Administration (FDA) originally approved the drug as a treatment for alcoholism. Over time, researchers have found that it can also be used to help addicts abstain from opiate drugs. Low dose naltrexone (LDN) may even help treat chronic behavior disorders, like compulsive eating. LDN is also effective in getting rid of certain infections and as a cancer treatment. This prescription medication is versatile in its uses. Not only can it do all of the things mentioned above, but, best of all, it’s also non-addictive and not a narcotic.
In the 1980s, the FDA officially approved Naltrexone for treating heroin and opium addiction. This medication is prescribed after detox, and, so far, has been highly successful and effective. It’s become a critical component in addiction recovery and comes with minimal health risks. Naltrexone can be administered either in a pill form or as an extended-release injectable known as Vivitrol. Patients can recover from opiate addiction, alcoholism or weight loss by taking the slow-release version of the drug. It comes in a 50 mg dose for treating addiction or an even lower dose for normalizing the immune system. It is highly effective in preventing drug and alcohol relapse.
Why is Naltrexone Such a Powerful Addiction Treatment?
Naltrexone has many facets in treating addiction. When combined with clonidine, it aids in the heroin or methadone detox process. This can be a major cost saver to the state and to the individual seeking addiction treatment. Naltrexone HCL is an oral medication with long-acting opioid blocking capabilities. It was originally marketed for heroin addiction. The Special Action Office for Drug Abuse Prevention initiated the creation of this drug in the 1980s. NIDA was on board with this initiative and put together clinical studies to study the side effects of naltrexone. NIDA determined that it has no organ or developmental toxicology. When compared to a placebo, this drug also yielded superior results for treating heroin abuse. Finally, in 1995, it was approved for preventing relapses in alcoholics trying to recover.
Various Prices of Naltrexone
The price if naltrexone hcl varies depending on the brand and type. There are 50mg, 100 mg, and 150 mg naltrexone tablets. There is also an extended-release injectable suspension that is good for a month.
- Revia, which is the brand name version of naltrexone, costs the most. There are a variety of generic tablets that cost less.
- Naltima, which is a 50 mg tablet, costs about $25 for 10 tablets.
- The price of generic Revia on some websites or at some stores may cost less than the actual brand name. For example, some places offer 30 tablets of generic revia, which contain 50 mg of naltrexone, for $31.50.
- The price of VIVITROL® is substantially higher than the tablets. The plus side is that it’s much easier for people to use this type of medication because they don’t have to remember to take pills every day.
- The price of VIVITROL® ranges from $1,300 – $1,700 per injection. There are co-pay savings programs that will cover up to $500 per month. Not all patients are eligible for this program. It’s dependent on the insurance carrier.
Naltrexone is a critical part of many addiction recovery treatment plans. This non-narcotic opiate blocker can stop addicts from using certain drugs or alcohol. It’s unique within the medical industry because it’s non-addictive. It also prevents users from feeling high or from feeling the effects of alcohol. This takes away the reward process of using substances in the first place. The reward is a powerful motivator that keeps addicts hooked. Naltrexone takes that aspect away from drug abuse or alcohol abuse. Naltrexone is an effective treatment for alcohol dependence. As mentioned above, it stops the pleasurable sensations that alcoholics associate drinking with. It isn’t a drug or alcohol substitute like many other addiction drugs. It reduces alcohol cravings. It can result in an alcoholic drinking less or stopping altogether. Think of this medication as an aid to recovery from drug addiction or alcoholism. It is not a cure. It should be used in conjunction with other types of substance abuse treatments. This includes holistic healing and behavioral therapy.
What is Naltrexone, and How Does it Work?
Naltrexone is an opiate blocker. It belongs to the drug family known as opiate antagonists. It works by blocking serotonin and dopamine from attaching to cells or nerve receptors in the brain, spine or gastrointestinal tract. The result is that the user will feel no effect from opiate drugs or alcohol. It stops the strong cravings that cause people to relapse. Naltrexone was originally only sold under the brand name Revia. It was available only in a pill form. It is now also available as a once-a-month injectable, which can be administered by a licensed physician. Injectable Naltrexone can also be administered by other licensed healthcare professionals in outpatient treatment settings. Those who drink while on naltrexone can still become intoxicated. The difference is that they won’t feel the same pleasurable feelings as before. In fact, they’ll feel sick. No one really knows what mechanism of action causes these effects. They only know that it can effectively inhibit further alcohol abuse or drug abuse. Reports have found that it successfully treats patients in three ways:
- Naltrexone reduces an alcoholic or drug addicts’ urge to use.
- Naltrexone 50 mg helps addicts to abstain from the substances they’re addicted to.
- Naltrexone blocks an addict’s desire to drink more if they do have a drink.
Withdrawal Symptoms and Naltrexone
There’s a dynamic relationship between this medication and the opioid receptors in your central nervous system (CNS). Basically, naltrexone can prevent impulsive actions that lead to relapse. It can do a lot for those who already in recovery. Patients must have already started on their sobriety before using this prescription drug. A huge question on many patient’s minds is, “Does naltrexone help with withdrawal symptoms?” The answer is both yes and no. It helps treat psychological withdrawal symptoms, like cravings. Those who take this prescription medication won’t feel the urge to drink alcohol or use drugs. They can focus more on their recovery. However, this medication does not treat physical withdrawal symptoms, like seizures or delirium tremens. This medication must not be used when the substance abuser still has opioids or alcohol in their body. Patients should have achieved abstinence for at least 5 days before using this drug. Otherwise, the combination of alcohol and opioids with naltrexone can lead to unwanted side effects. Patients can stop using naltrexone without having to worry about withdrawal symptoms. This is a common worry with other medications used in addiction treatment. For example, many patients can develop a secondary addiction to methadone and even buprenorphine. Fortunately, it’s not possible for patients to develop naltrexone withdrawal symptoms because they don’t build a physical or chemical dependence on it. Naltrexone side effects are usually short-lived and mild. Most patients report that they don’t feel the medication. They don’t feel “high” or “down”. They simply feel more stable.
How Long Does It Take for Naltrexone to Start Working?
Naltrexone’s effects will usually kick in within minutes of ingestion or within minutes of the injection. The effects usually kick in quicker if the drug is injected into the body. This is because it can easily travel to the opioid receptors in the organs. Within minutes, most patients will usually find that they no longer have a craving, a desire or a need to drink alcohol or use drugs. These cravings can be drastically reduced, or they can be eliminated completely. Some patients truly do not feel the need to drink or use opioids after they take this prescription medication. They can start to focus on other parts of their recovery plan. Naltrexone effects also kick in within the first dose. If it was injected, these effects will last for an entire month. It’s important not to stop taking naltrexone once it has started working. Patients need to continue to use this medication in order to achieve a full recovery. This takes time. Although recovering substance abusers are not expected to take naltrexone for long, they usually will need it for a couple of weeks. This gives their body and brain enough time to reset. Naltrexone can help alcoholics to stop drinking safely. It can also help opioid users learn how to live without the drug. The road to recovery can be a long journey. Without the cravings, these people can start to rebuild their lives.
What is Low Dose Naltrexone (LDN)?
LDN is a low dose version of naltrexone. It’s been FDA approved to normalize the immune system. This is effective for people who have HIV/AIDS, cancer, CNS disorders, or autoimmune diseases. Low dose Naltrexone is a low-cost treatment option for people living in developing countries. For example, in Africa, LDN can be used as low-cost therapy for HIV and AIDS. It’s beneficial because it also comes with no side effects. So how is it that the 50 mg of Naltrexone can block the pleasurable effects of heroin use and can be a treatment for cancer? How does LDN work? Low dose Naltrexone also blocks the receptors responsible for producing opioid hormones in the brain and adrenal glands. Many internal organs have receptors for these hormones. Lower dose Naltrexone stimulates the body’s immune system, which can enhance a person’s response to HIV or cancer. There have been some dramatic accounts of LDN and its’ ability to fight against cancer. They’ve also found that LDN can quickly take control of autoimmune diseases like lupus. In short, LDN activates the body’s defense system by giving the immune system a boost.
What Other Situations Can Low Dose Naltrexone Be Prescribed For?
In the substance abuse industry, naltrexone is used to treat opioid addiction and alcohol addiction. This is its main role. It helps with long-term sobriety, and it helps manage cravings. It’s been hailed as a ‘wonder drug’ by many people. Low Dose Naltrexone (LDN), however, is much more versatile than that. LDN can be prescribed for cancer treatment, like lymphoma and pancreatic cancer. It’s very effective. In fact, a study of 354 cancer patients found that 86 patients experienced “significant tumor shrinkage” by at least 75%! The condition of another 125 patients stabilized upon using LDN. These patients were also well on their way to remission. Surprisingly, LDN has many other uses as well. Since it can boost a person’s immune system, it can treat many other conditions. LDN can also be prescribed to treat other autoimmune conditions like:
- rheumatoid arthritis
- Crohn’s disease
It can also improve the symptoms of Post Traumatic Stress Disorder (PTSD). This means that LDN can be helpful in treating co-occurring disorders. It can help patients stabilize their mood while they’re also in recovery. It’s a win-win situation. LDN is a safe and effective protocol for at least a dozen other chronic conditions. It’s a popular treatment option for many diseases. In short, low doses of naltrexone can be prescribed for uses other than drug addiction and alcohol addiction.
Naltrexone for Alcoholics
Naltrexone works by helping people drink less alcohol or completely abstain from it. Additionally, it makes drinking less desirable. The nature of the drug makes it relevant when used as part of a whole treatment plan. A complete treatment program will include counseling, support groups like 12-step programs (AA), and changes in lifestyle. Alcohol dependence will hit a person on many levels. The physical and physiological addiction, as well as the reason behind the addiction, can become overwhelming. When a person is physiologically addicted to alcohol, they have to continue upping the amount they drink. This is because they have developed a tolerance to it. It’s also so that they won’t experience withdrawal symptoms. Withdrawal symptoms of alcohol can be extremely dangerous, even life-threatening. A main symptom of alcoholism is cravings that come with withdrawals and increased tolerance. Those who are on naltrexone will have fewer thoughts of drinking. This phenomenon helps prevent relapse. Naltrexone can alleviate some of the main problems that come with abstinence. This makes recovery a more manageable experience. Clinical trials proved that this medication is effective in limiting both the number and the duration of drinking days among alcoholics.
Can You Drink Alcohol While Taking Naltrexone?
You can drink alcohol while taking naltrexone. This prescription drug will not sober you up. It also will not cause any dangerous side effects. Those who drink alcohol while taking naltrexone will still experience both cognitive and physical impairments. This includes:
- Slowed rates of thinking
- Decreased response time
- Loss of motor coordination
Those who take naltrexone when drinking won’t become violently ill. It is not a form of aversion therapy, like disulfiram. They will, however, also not experience any pleasurable effects of drinking alcohol. This phenomenon may cause them to have less of an urge to drink more alcohol. It can help reduce their alcohol intake. Due to the unique nature of naltrexone, this prescription drug can be effective in reducing how much alcohol is consumed. However, it is not exactly effective in promoting complete abstinence since users can still drink. They can drink any type of alcoholic beverage that they want, like beer or hard liquor. Naltrexone won’t stop them if they are keen on doing so. With that said, since naltrexone can reduce alcohol consumption, some researchers are exploring the merits of the Sinclair Method. This method suggests that recovering alcoholics take a tablet of naltrexone one hour before they drink alcohol. This may help them drink less and feel cravings that are less intense. Naltrexone will not and cannot reduce any short-term or long-term effects associated with drinking. Those who continue to drink will still be at risk for chronic alcohol abuse, cardiovascular damage, kidney damage, and more. They can still develop strokes, seizures, and even dementia. They are also still at risk for developing delirium tremens.
Naltrexone for Opiate Addiction
Opioids, like heroin, produce a euphoric effect that encourages further use. When these effects are blocked with a narcotic antagonist, the reasons for using are reduced. Drug users can still try to use heroin or prescription opioids when they’re on naltrexone, but they will perceive it differently when there is no effect. This eventually results in the termination of opioid abuse. Naltrexone is a potent mu antagonist with very little associated risk. As a result, it doesn’t reinforce further addictive behavior. There is no potential for abuse. Due to these reasons, naltrexone is regarded as a highly favorable way of encouraging recovery against opioids. Addiction treatment professionals believe naltrexone is an excellent way to motivate abstinence. For the best results possible, the patient has to also be motivated to abstain from opioid use. The administration of naltrexone for opioid addiction should be just one element of treatment. Other parts of treatment should include:
- Rehabilitation measures.
- Compliance monitoring.
- Counseling and twelve-step meetings like NA
- A total lifestyle change.
The Danger of Continuing to Abuse Opioids While Taking Naltrexone
If you abuse opioids or opiates while on naltrexone, you won’t feel any effects. This is both a good thing and a bad thing. It’s a good thing because the lack of pleasurable results will stop many drug abusers from using the drug again. After all, they no longer have a reason to take opioids or opiates if they’re not going to get high from it. The fact that naltrexone can prevent opioid users from feeling the drug can also be a bad thing. It may encourage some users to take more and more of the drug if they feel like they need to get high. This enhances the risk of an opioid overdose. Recovering drug abusers may take large doses of opioids, leading to an overdose. Although naltrexone blocks the pleasurable effects of the opioids, it does not prevent them from doing serious harm to the body. It’s possible for drug users to fall into a coma or even die. Other signs of an overdose include:
- Difficulties breathing
- Slowed or shallow breathing
Those who take naltrexone are also more likely to be sensitive to lower amounts of opioids. They may not realize this. After taking the medication for a while, they can overdose if they take the same opioid dose as before. Their bodies simply cannot handle it. Fortunately, naloxone can reverse the effects of an opioid overdose. Its effects will kick in within 5 to 30 minutes. It can save a person from dying. Those who have overdosed should still seek immediate medical attention even after taking naloxone.
Side Effects of Naltrexone and Current Use of Opiates
Naltrexone comes with very few side effects. Side effects can appear when mixing opiates while taking naltrexone. If someone is currently taking opiates and also uses naltrexone, they’ll experience instant withdrawal systems. Since naltrexone is an opiate antagonist, it stops the opiate effects from reaching the brain. If a person is relying on a prescription painkiller to help numb pain, they’re out of luck. Similarly, if a person takes heroin, there will be no feeling of well-being or euphoria. This is why patients who are taking naltrexone will often carry a card. In the event that something happens to them, medical staff will know that they’re on this drug. This will determine the type of pain medications that are prescribed. Not all painkillers will be effective for someone taking naltrexone. If a patient is undergoing elective surgery, they should stop taking naltrexone three days before the surgery. The main drugs used to alleviate post-surgical or chronic pain are opiates. If naltrexone is in the patient’s system, the pain relievers are unable to “latch” onto the brain. This means that the patients feel the brunt of the pain from the surgery. Naltrexone doesn’t have an impact on other medications. It can be taken with antibiotics and non-opioid painkillers. Due to the effects of naltrexone, it’s important that medical professionals know when a patient is taking this medication. Another thing to note is that naltrexone is broken down by the liver. If a person is taking medications that affect liver function, it could affect the naltrexone dose.
Sudden Opioid Withdrawal
Anyone who is interested in taking naltrexone must be opioid-free for at least 7 to 14 days. Those who neglect to do so may experience opioid withdrawal symptoms. This is also known as sudden opioid withdrawal. Sudden opioid withdrawal can be severe. It may require hospitalization. Some of these symptoms include:
- Abdominal cramps
- Bone/joint pain
- Muscle aches
- Runny nose
To prevent sudden opioid withdrawal, patients must make sure that they are opioid-free before receiving any type of injection or taking any tablet. Most rehab centers can treat the withdrawal symptoms, and help ease their intensity.
Why Does Naltrexone Work for Weight Loss?
As of 1995, the FDA approved naltrexone for the treatment and intervention of alcohol abuse. This drug is useful and effective in treating impulse control disorders, like eating disorders. The most prominent reason why people are overweight is that they overeat. The FDA approved weight loss drug incorporates naltrexone with bupropion. While bupropion decreases a person’s appetite and prevents depression, naltrexone curbs hunger, and food cravings. Naltrexone can also be used as a weight-loss medication on its own. Although this treatment plan is not approved by the FDA, there are many studies that suggest that this technique can be helpful in weight loss. LDN can help encourage weight loss in many different ways. Here are some of the ways that it can work its magic:
- Reduces insulin resistance and improves insulin sensitivity
- Stimulates hormone growth and production, which improves lean muscle mass production
- Changes how much a person eats to match how much energy they’ve expended
- Improves a person’s sleep to moderate blood sugar levels and manage inflammation
- Improves thyroid function
What is Naltrexone 50 mg Used For?
Addiction specialists may prescribe a 50 mg naltrexone dose for the treatment of addiction, recommending a dose a day. It will block the physiological, subjective effects of heroin or morphine for 24 hours. It does the same thing for alcoholics. After detox, a recovering alcoholic or opioid addict should stay in an inpatient program. There, staff can ensure that patients adhere to their prescription schedule and dose. Addicts attending outpatient treatment may be prescribed a higher dose, such as 100 mg or 150 mg. This allows patients to visit the clinic every 2-3 days as opposed to daily.
The HCL in naltrexone HCL stands for “hydrochloride.” The HCL makes it easier for the body to absorb the drug. HCL is also used in medicine to make it more stable and soluble. The hydrochloride causes the medication to become longer-lasting than its ‘freebase’ form.
Extended-Release Naltrexone (Vivitrol)
Instead of taking tablets, some patients feel enticed to take Vivitrol, which is an extended-release version of the drug. Vivitrol is also a non-addictive medication. It contains the same active chemical compounds and the tablets. The only difference is that it is administered in the form of an intramuscular injection. Patients only need to get the injection once a month. This makes it easier for patients to adhere to a prescription schedule or dose. They do not have an opportunity to mess with the dose. Also, all patients will receive the same injection dose. It doesn’t matter whether they’ve abused the drug for a long period of time or whether they abused alcohol or opioids. Since the active ingredient in Vivitrol is naltrexone, Vivitrol is also an opioid antagonist. It works in the same way as the tablets. IT creates a barrier that blocks opioid molecules from attaching to the receptors. Patients must detox before they take the extended-release version of naltrexone. This is because patients can experience unsavory side effects if they still have alcohol or opioids in their system. Vivitrol is incredibly effective. In a 6-month, double-blind, placebo-controlled, randomized clinical study, those who took Vivitrol:
- Experienced 90% opioid-free weeks where they did not even touch the drug at all
- Experienced a 55% decrease in cravings
- Were 17 times less likely to relapse as a result of a physical dependence
- Were willing to stay in treatment for longer
Patients who took Vivitrol were willing to stay in treatment for over 168 days. This gives their body ample time to adjust and to reset. Although a 28-day detox and rehab program is effective, those who continue treatment via outpatient programs or more are even less likely to relapse.
Benefits of Choosing Vivitrol Over Other Types of Medications
There are many reasons why many addiction specialists recommend Vivitrol over other drugs and other treatment methods. Some of the benefits that Vivitrol can offer include:
- Being non-addictive. There is zero potential for abuse, which means that patients won’t develop a secondary addiction. They won’t suffer any consequences even if they do not adhere to the prescription schedule. It’s impossible to develop both a physical or chemical dependence on this medication. Other medications come with a potential for abuse. They can be addictive, and it’s possible for patients to develop a secondary addiction.
- Being easy to administer. Vivitrol is a once-a-month injection. There’s nothing complicated about that. The same dose is also used with every patient.
- Having a goal of total abstinence. Unlike other MATs and ORTs, Vivitrol helps patients achieve total abstinence. They no longer feel any joy from using the drug.
- Being long-lasting. Vivitrol lasts for an entire month. Other treatment options have a shorter-acting mechanism of action. For example, Buprenorphine only lasts for about 24 to 60 hours.
- Having a higher adherence and compliance rate. It’s much easier for patients to stick to a schedule when it’s simple. Vivitrol injections do not get any simpler. Patients are more likely to stick with the schedule, so they have a better shot at recovery.
- Being associated with fewer side effects. Patients are more comfortable during the addiction recovery process. This means that they’re more likely to succeed.
Vivitrol also has a shorter treatment length. Most patients will usually use this drug for anywhere from 6 months to a year. Clinical studies have also proved that this medication is effective.
Other Addiction Treatment Medication Options
Naltrexone is not the only medication for treating opioid or alcohol addiction. There are many other alternatives. Those who are struggling with opioid or opiate abuse may also be eligible for Opiate Replacement Therapy (ORT). Those who are struggling with alcohol abuse may be eligible for medication-assisted treatment (MAT). ORTs are a subcategory of MAT. MATs, however, are not ORTs. Let’s take a look at the differences below.
Opiate Replacement Therapy (ORT)
ORT basically involves the use of weaker opioids, like methadone, Suboxone and Buprenorphine. These medications stimulate the same opioid receptors. As a result, patients will not experience withdrawal symptoms that are as intense. These medications are easier to manage. They’re also easier to taper off of. There are two different types of ORT. There are full opioid agonists and partial opioid agonists. Full opioid agonists, like methadone, work in the same way as heroin. They stimulate the same receptors and can cause the same effects. They can be just as addictive, and patients can get high if they take a larger and larger dose. Due to this reason, patients must adhere to the prescription schedule and dose. Partial opioid agonists, like Suboxone, are a bit different. They come with a maximum threshold. Patients will not get high if they take a larger and larger dose. They also won’t develop a dependence on this drug. Once a certain dose is reached, patients will not feel anything more if they take more of the drug.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) involves the use of medications to ease withdrawal symptoms. These medications are not like ORT medications, as they are not addictive. They also are non-addictive. MATs usually treat specific symptoms. There are many different options to choose from. There are MATs for both opioid and alcohol addiction. Medications used to treat alcohol addiction include:
These medications work in different ways. The dose will also need to be tailored to each patient based on his or her biological makeup.
Naltrexone Side Effects
There are minimal side effects when taking naltrexone. Less than 10% of people suffered from the following side effects:
Most patients state that if they did experience side effects, they were not intense and didn’t last long. The only serious side effect to be wary of is liver damage or hepatitis. To make sure that patients won’t sustain significant liver damage, they are encouraged to get blood tests to make sure that their liver is functioning properly. Signs of a liver problem include:
- Stomach pain or abdominal pain that lasts for more than a few days
- Dark urine
- Extreme fatigue or tiredness
- Yellowing of the whites of the eyes
Patients may need to stop taking naltrexone if it is damaging their liver. Doctors will weigh the benefits and risks of taking naltrexone. They may encourage patients to continue taking this drug if the benefits outweigh the risks. The side effects may not be nearly as dangerous to the body as abusing alcohol or drugs were. Naltrexone is a powerful tool for fighting addiction. It prevents relapse in a way that is non-addictive to the addict. It can be used with other drugs, as long as they’re not opioids or drugs that interfere with the liver. This medication is a great addition to any substance abuse treatment plan. It is fundamental in helping addicts recover fully. Once again, a complete treatment plan will also include counseling, twelve-step programs, holistic healing like meditation, and one-on-one therapy. There is no need to taper off of naltrexone, and patients will not become dependent on it.