What is Drinking on Naltrexone Like?

Prescription medication that reduces the feeling of reward or pleasure after you drink can be a very effective tool that many people aren’t aware of. One of the most common medications for treating alcohol use disorder is called naltrexone. Many people use naltrexone to combat alcohol cravings and reduce their intake, while others use it with the goal of achieving and maintaining complete sobriety. No matter your goal, you might be wondering what you may experience while drinking on naltrexone. To answer this question, it’s important to understand how naltrexone works. Below, find medically-reviewed answers to common questions about naltrexone:

What Does Naltrexone Do When You Drink Alcohol?

Naltrexone limits your ability to feel rewarding or pleasurable effects after drinking alcohol, and thus reduces your craving for it. The way naltrexone treatment works is by altering what alcohol does to your brain. Normally, alcohol stimulates the release of biological molecules, called endorphins, in the brain that make you feel that happy and euphoric feeling when you drink. Naltrexone belongs to the class of drugs called opioid antagonists. An opioid antagonist blocks endorphins from binding to their receptors, so you no longer feel the same feelings of elation when you drink. Therefore, it’s important to note that when drinking on naltrexone, you may not feel the same pleasurable effect you used to feel when drinking alcohol. Naltrexone is used in medication assisted treatment to treat both alcohol dependence and opioid use disorder. For the purpose of this resource, we’ll be specifically discussing naltrexone and alcohol consumption. 

How Soon Does Naltrexone Start Working?

With Monument’s online alcohol treatment program, you’ll connect with a physician who will prescribe medication if they deem it safe and appropriate based on your medical history and goals. It’s important to let your physician know about any preexisting physical or mental health conditions, as well as any additional medications you’re taking. They will also be able to let you know if you’re showing signs of alcohol dependency, and are at risk for alcohol withdrawal.

If prescribed naltrexone, your physician will likely dose naltrexone at the FDA-recommended daily dose of 50 mg. Naltrexone’s duration of action is approximately 24 hours. Therefore, an individual will have a therapeutic dose throughout the day.

In general, oral naltrexone is absorbed well by the body, making it very effective for most people who take it. Once you take naltrexone, the medication reaches its maximum effect in about one hour, so it begins working very quickly. If you don’t experience the naltrexone benefits immediately, don’t get discouraged. You can discuss your experience with your healthcare provider, and they can provide suggestions to improve results. While naltrexone therapy can be effective alone, many people see the greatest benefit when combining medication assisted treatment with counseling and behavioral therapies. Also, if naltrexone isn’t right for you, you might explore other medication options such as disulfiram.

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What Happens if You Drink While on Naltrexone? 

A common question is whether or not it is harmful to drink alcohol while taking the medication. The short answer is this: while there is no risk of a dangerous reaction between naltrexone and drinking alcohol, naltrexone does not prevent the negative effects of alcohol use, such as judgment impairment, slowed thinking and worsened motor skills, among others. Naltrexone also does not address withdrawal symptoms. 

How naltrexone works is by lessening the experience of pleasure from drinking. This does not mean that the alcohol you consume will not affect you. Drinking on naltrexone still subjects you to the same types of psychological and behavioral risks of drinking without naltrexone. Since naltrexone prevents you from feeling the same way you usually do when you drink alcohol, it can be difficult to realize that you are intoxicated. So, to be safe, you should still avoid activities that you normally would not do when you drink, like driving, operating machinery, or engaging in activities that rely on motor skills and coordination of movements.

While it doesn’t counteract the negative side effects of drinking, naltrexone does reduce alcohol craving, and is an effective tool for ultimately reducing your alcohol intake and living a healthier life. This stems from your brain creating lower feelings of reward and pleasure when alcohol is consumed. As for many others, one of our members shared seeing success with naltrexone treatment to slowly reduce alcohol intake. Over time, the pleasurable effect decreased and deliberate alcohol consumption turned into healthier habits or no drinking at all.

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Do You Still Feel Drunk While Taking Naltrexone? 

Drinking while on naltrexone is unlikely to make you feel the same level of intoxication or ‘buzz’ you experience when drinking without it. 

However, when drinking on naltrexone, the alcohol can still:

  • impair your judgment
  • impair your ability to think and perform actions normally 

Keep this in mind if you reach for a drink while taking naltrexone. 

People who drink alcohol after taking naltrexone have described the feeling as lacking the ‘buzz’ generally associated with alcohol intake, with some people describing it as drinking any other beverage.

Can Drinking on Naltrexone Make You Sick? 

You might be wondering what it feels like to take naltrexone and drink alcohol. This medication will not make you feel sick if you drink alcohol while taking it. 

In contrast, another medication used to treat alcohol use disorder, disulfiram, increases alcohol sensitivity when consumed. This increased sensitivity can cause you to become very ill, as disulfiram causes the same effects of a hangover almost immediately after alcohol is ingested. Naltrexone does not have the same effect. 

Clinical trials have shown that naltrexone is safe and well-tolerated when taken while still drinking.

How Does Taking Naltrexone Make You Feel?

While naltrexone is generally well tolerated, how you feel while taking it can vary by individual. Some people may have no adverse reaction from naltrexone at all, while others may experience side effects such as nausea and headaches. Fortunately, side effects can often be managed or mitigated with the guidance of your healthcare provider by adjusting dosage or when you take medication, among other factors. Some people may notice that their cravings for alcohol plummet almost immediately after starting naltrexone, while for others it takes weeks or months to reap naltrexone’s benefits

People typically experience fewer alcohol cravings while taking naltrexone because it blocks the “euphoric effects” of alcohol. Some people also describe a “full” sensation if they drink alcohol while taking naltrexone, curbing their desire to drink more.

What Are the Risks of Drinking on Naltrexone?

Naltrexone doesn’t have many risks or dangerous interactions with other medications. However, you should speak to your healthcare provider to understand how naltrexone may impact you. It’s important to note that naltrexone should never be mixed with opioids, as this interaction can have deadly consequences. While it’s safe to combine alcohol and naltrexone, it’s important to keep in mind that naltrexone doesn’t prevent the risks associated with alcohol consumption, such as reduced motor skills and impaired cognitive abilities.You can still get intoxicated while drinking on naltrexone, which is why it’s important to take precautions, such as not operating a vehicle. Psychologically, you may notice that you feel less buzzed than you typically would. In some cases, this lack of “buzz” can cause someone to not realize how much alcohol they’ve consumed, leading them to drink more than what’s healthy or safe. 

Can You Overdose on Alcohol While Taking Naltrexone?

If you consume dangerous amounts of alcohol while taking naltrexone, you’re at the same risk for alcohol overdose than if you weren’t taking the medication. Naltrexone doesn’t prevent the physical side effects associated with consuming alcohol, or reduce your blood alcohol concentration (BAC). Instead, it reduces your cravings for alcohol. Those who drink alcohol primarily for its physical side effects, not mood-altering effects, may not feel naltrexone is as effective for them. 

In some cases, naltrexone can also have toxic effects on the liver. Therefore, combining naltrexone with excessive amounts of alcohol, which also damages the liver, can impair your liver function and lead to liver complications. Those with prior liver issues should consult their doctor before taking naltrexone.

How Long Do Patients Take Naltrexone?

The average duration of medication assisted treatment varies by individual. You and your doctor will discuss a timeline that makes sense for you, and this can change over time. That said, most people take naltrexone for at least 12 weeks, and many physicians recommend taking naltrexone for 12 months or more. It’s important to remember that naltrexone is neither a quick fix nor a miracle pill, and can take time and the support of other tools to reach its maximum effectiveness. For example, naltrexone is typically more effective when used in combination with alcohol therapy. The good news is that there doesn’t seem to be any danger of using naltrexone in the long-term, particularly if it’s done under the supervision of a physician.  

How to Use Naltrexone to Reduce Drinking

Many people drink because it provides them with a feeling of pleasure, euphoria, or relief. Naltrexone is an effective tool for reducing alcohol consumption because it makes drinking less pleasurable. Naltrexone prevents the endorphins released when drinking from binding to receptors in the brain, blocking the pleasurable effects of alcohol. Drinking without this sense of elation or euphoria ultimately becomes less appealing, and over time, people often experience fewer cravings and drink less or not at all. 

What to Know Before Using Naltrexone

Before you begin using naltrexone, it’s important to talk to your physician about your health history and current medications to determine if naltrexone is safe and appropriate for you. It’s also helpful to know that it may take time for your alcohol cravings to lessen after you start taking naltrexone. Building your sobriety toolkit with other methods of support, such as alcohol therapy or alcohol support groups, are great steps to take as you begin naltrexone treatment.

Naltrexone Side Effects

Common side effects of naltrexone include headache and nausea. That said, naltrexone is generally well-tolerated. If you experience side effects from naltrexone, you can discuss your dosage with your physician and make adjustments to help mitigate any negative effects. You may decide to take a smaller dose, or change the time of day in which you take naltrexone. Many people also find that symptoms reduce with time.  

Is Naltrexone Treatment Right For You?

How do you decide whether naltrexone is right for you? You don’t have to make this decision alone. At Monument, we connect you to a licensed physician to discuss your options. They will learn about your medical history, preferences, and goals, and let you know what is safe and appropriate. If medication isn’t right for you for any reason, don’t be discouraged. You can achieve your goals with the support of other alcohol treatment options like community support and specialized therapy. 

We understand that finding the right approach to change your drinking habits can be challenging, and we’re here to connect you to expert clinicians to guide you along the way. You can do this! At Monument, you can connect with a physician online to discuss if medication to stop drinking is right for your recovery journey, and get ongoing care. 

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Sources:

  1. National Library of Medicine. “Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review, https://pubmed.ncbi.nlm.nih.gov/15200577/.” Accessed Dec. 10, 2020.
  2. National Library of Medicine. “Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism, https://pubmed.ncbi.nlm.nih.gov/11139409/.” Accessed Dec. 10, 2020.
  3. National Library of Medicine. “Naltrexone for the Management of Alcohol Dependence, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565602/.” Accessed Dec. 10, 2020.
  4. JAMA Network. “Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings, https://jamanetwork.com/journals/jama/fullarticle/1869208.” Accessed Dec. 10, 2020.
  5. Journal of Experimental Psychology. “Opioids and social bonding: Effect of naltrexone on feelings of social connection and ventral striatum activity to close others, https://psycnet.apa.org/doiLanding?doi=10.1037%2Fxge0000674.” Accessed on June 6, 2022.
  6. National Institute on Alcohol Abuse and Alcoholism. “Answers to Frequently Asked Medication Questions, https://pubs.niaaa.nih.gov/publications/combine/faqs.htm.” Accessed on June 6, 2022.

Important Safety Information

Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use in patients with active liver disease must be carefully considered in light of its hepatotoxic effects. In the treatment of alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list.

The most common side effects of Disulfiram may include drowsiness, tiredness, headache, acne, and metallic-like taste in the mouth. Call your doctor if you have signs of serious side effects such as decreased sexual ability, vision changes, numbness of arms or legs, muscle weakness, mood changes, seizures, or confusion. Do not take Disulfiram if you are allergic to any of the ingredients. If you begin to have signs of an allergic reaction, then seek immediate medical attention. Avoid consumption of alcohol while taking this medication, as it may lead to adverse side effects. Talk to your doctor about the history of your medical conditions including if you have or have had diabetes, underactive thyroid, brain disorders, liver or kidney disease, personal or family history of regular use/abuse of drugs. Certain drug interactions may lead to serious adverse side effects. Let your doctor know about any other medications you are taking. This is not a complete list of potential adverse events associated with Disulfiram. Please see Full Prescribing Information for a complete list.

Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.

About the Author

Randy SmithBased in Portland, OR, Randy works on the marketing team at Monument managing all things content.