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How to Treat Addiction & Abuse with Naltrexone
This Page was last reviewed and changed on May 17th, 2022
Naltrexone is a drug that is commonly prescribed as part of a comprehensive recovery programme from alcoholism and drug addiction. It works on the brain to decrease the cravings experienced for alcohol as well as by blocking the effects of drugs such as opioids. It is typically prescribed after drug detoxification/alcohol detoxification and is taken either orally or by injection into a muscle.
Medication is not always appropriate for the treatment of substance abuse and addiction, usually depending on the type of substance that was being abused. Sometimes medications are prescribed during the detoxification process to relieve the withdrawal symptoms or prevent these from occurring. These medications are usually replacement drugs, or the substance being withdrawn. Using replacement drugs can help to ease the severity of withdrawal symptoms and make the detox process less uncomfortable.
Medication may also be prescribed on an ongoing basis to help with abstinence maintenance. It could be the case that you require extra assistance to stay away from the substance you have been addicted to. Some medications can make it unpleasant to drink alcohol or take drugs, for example, while others will help reduce cravings and assist with relapse prevention.
How to Choose the Right Medication
Medication to treat substance abuse and addiction will be prescribed by a fully qualified medical professional who will fully assess your situation to determine what is the best treatment option for you and your situation. Doctors prescribe appropriate medication based on individual circumstances. He or she will take your age, weight, overall mental and physical health, and the type of addiction you have into account before prescribing any medication.
What is Naltrexone
Naltrexone is a powerful opioid antagonist that is primarily used in alcohol detox, with studies showing that it can help reduces the amount of alcohol one consumes. It decreases the desire to drink but should be used as part of a programme of detoxification and rehabilitation rather than a treatment in and of itself.
Injectable naltrexone is used to decrease cravings for other substances such as heroin as well. Nevertheless, it can take a number of weeks before these decreased cravings are noticed.
Brand Names for Naltrexone
History of Naltrexone
Naltrexone was synthesised in 1963 by the small New York pharmaceutical company Endo Laboratories. In 1965, it was discovered to be a very strong opioid antagonist and was characterised by Blumberg, Dayton, and Wolf, who recognised the advantages that it had over other opioid antagonists. These advantages included a long duration of action that meant a once-a-day administration was possible.
In 1967, Endo Laboratories filed an application for the patent; at the time it was known under the developmental name of EN-1639A. In 1969, DuPont acquired Endo Laboratories and in 1973 the company began testing the drug in clinical trials for the treatment of opioid dependence.
In 1984, approval from the US FDA was granted and naltrexone was marketed under the brand name of Trexan for opioid dependence. In 1995 Trexan was rebranded as ReVia and approved for the treatment of alcohol dependence. The intramuscular injection version of the drug was approved for use in alcohol dependence in 2006 and for the treatment of opioid dependence in 2010, under the brand name of Vivitrol.
Is Naltrexone Addictive?
As naltrexone is a drug used to block the euphoria associated with opioid substances, there is little potential for abuse. It is therefore not classed as an addictive drug.
What is the Mechanism of Action
Naltrexone’s exact mechanism of action is not yet fully understood but it is believed that, as an opiate antagonist, it binds to the brain’s opioid receptors and works by blocking the feelings of pleasure that such drugs typically induce. Naltrexone can suppress the effects of alcohol and opioid drugs and consequently reduces feelings of pleasure and cravings.
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How Long Does It Take for Naltrexone to Work?
While the effects of naltrexone typically begin to show within thirty minutes of taking it, craving reductions for opioid drugs may take several weeks to take effect.
What are the Side Effects of Naltrexone?
Facts/Statistics on Naltrexone
Using naltrexone could make you more sensitive to opioid drugs. Therefore, if you use these in the future, you could be at higher risk of an overdose if using the same amount as before.
Naltrexone oral tablets are typically taken once per day; injectable naltrexone is administered once per month.
Studies Done on Naltrexone
A study on alcohol and alcoholism published in January 2001 sought to determine the safety and efficacy of naltrexone in the treatment of alcoholism. Eight double-blind placebo trials took place in five different countries. When the results were examined, it was found that while naltrexone is effective when used to reduce alcohol consumption, it had negligible effect when used during abstinence.
The study also concluded that ‘naltrexone should be administered to patients who were still currently drinking’ and that ‘the instructions should be to take naltrexone only when drinking was anticipated’.
Another study published in The Lancet compared naltrexone to buprenorphine and results showed that while naltrexone is just as effective as buprenorphine once the patient has started taking it, it cannot actually be started until after detoxification had been completed. This is because naltrexone only works once all opioids had been eliminated from the system during a programme of detox. The conclusion was that while both drugs were effective once treatment had begun, buprenorphine had the advantage in that it can be administered before a full detox had been completed.
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