If you think your relationship with alcohol has become unhealthy, you are not alone. The good news is that excessive drinking does not have to be permanent. Deciding that you want to cut down on your alcohol consumption is the first step towards developing a healthy relationship with alcohol that can transform every aspect of your life.
You might be wondering whether there is a medication to stop drinking that you can take to help you reach your goals for cutting back or getting sober. And while many people don’t know about these options, the answer is yes.
There are FDA-approved medication options that have been proven effective in reducing alcohol consumption. Naltrexone is a great option for people who want to reduce their cravings for alcohol, which naturally helps them reduce alcohol consumption and achieve goals for moderation or sobriety.
What is Naltrexone?
Even if you haven’t heard of naltrexone until now, the medication has been around for a long time. So what is naltrexone used for? Naltrexone was initially marketed in 1984 for the treatment of opioid use by reducing opioid cravings.
Based on naltrexone’s positive results as an opioid treatment method, it was not long before it was found to help treat alcohol use disorder as well.
How Does Naltrexone Help People Drink Less?
Today, naltrexone is one of the leading medications used to treat alcohol use disorder. The ability of naltrexone to reduce alcohol consumption was initially observed in the 1980s. Since then, several clinical trials have demonstrated the ability of naltrexone to reduce alcohol dependency.
So what does naltrexone do to treat alcohol use disorder? Naltrexone can help you change your alcohol usage habits in two ways. It helps you either:
- reduce your alcohol usage
- abstain from drinking alcohol altogether
Currently, naltrexone is sold under the trade names Vivitrol and ReVia, among others. In addition, the medication is being marketed as naltrexone hydrochloride. Your physician can walk you through your options for naltrexone, including recommended dosage, when to take it, and what to expect.
While researching naltrexone, you might come across another related medication called naloxone. This medication is different from naltrexone and is not used to treat alcohol use disorder. Naloxone is a short-acting drug that works similarly to naltrexone, but it is only used to treat opioid dependence. Naltrexone functions in the body longer compared to naloxone and is better suited to treat alcohol use disorder. While both of these medications have been used in opioid dependence neither of them is an opioid medication so there isn’t risk of dependence or withdrawal upon cessation of the medication. They both work by blocking opioid receptors in the brain.
How Effective is Naltrexone?
Naltrexone is effective in reducing alcohol consumption, and can also help prevent a setback from occurring while you are in the process of changing your drinking habits.
A review of 19 clinical trials examining the effect of naltrexone on alcohol use disorders found that short-term treatment of 12 weeks or less lowered the amount of total alcohol consumption and the number of drinks consumed per day. It also increased the duration of sobriety in people who took the medication, with a longer time taken to relapse during treatment with the naltrexone. While naltrexone can be effective even in shorter time periods, as mentioned above, your physician will likely recommend taking it for approximately one year to maximize your likelihood of achieving long-lasting goals.
Further studies have also shown that even if you experience a setback after the naltrexone treatment period is finished, the likelihood of resuming former habits of unhealthy alcohol use is lower.
These are all significant factors for someone who wants to overcome unhealthy alcohol consumption. Overall, naltrexone has been thoroughly analyzed in clinical studies and found to be a safe and effective way to help you change the way you use alcohol.
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Naltrexone in Combination with Therapy
There are also studies that have shown the effectiveness of naltrexone in combination with specialty alcohol therapy, including cognitive behavioral interventions (CBI). CBI includes treatment modalities such as motivational interviewing and cognitive behavioral therapy. All therapists on the Monument platform are proficient in these modalities. It’s been found that prescribed naltrexone with therapy like medical management (MM) or combined behavioral intervention (CBI) produced some of the best outcomes when it came to reduction of drinking.
However, medication may not be for everyone. We recommend you speak with your physician to help determine which approach will best achieve your goals.
How Does Naltrexone Work?
First, let’s take a look at how alcohol works in the body when consumed. Alcohol alters several neurochemical pathways in the brain and when ingested, it can reach the brain within just a few minutes. The feelings of euphoria or reward that you feel when alcohol is consumed are caused by how alcohol alters these neurochemical pathways. The brain’s major biological pathways affected by alcohol are called the glutamate, γ-aminobutyric acid (GABA), dopamine, and opiate systems.
Initially, alcohol stimulates the dopamine and opiate systems in the brain that give you feelings of craving, reward, and dependence when you consume alcohol. Research has shown that overuse of alcohol lights up these areas of the brain much more in people who overuse alcohol than in more mild drinkers. Natural substances, called endorphins, present in the brain are also released during intoxication with alcohol. These endorphins contribute to pleasure and dependency on alcohol.
The effects of alcohol on an individual’s brain also explain why drinking in moderation versus drinking in excess have such different effects on the body. A common question we get asked is – ‘is alcohol a stimulant or depressant?’ While low doses of alcohol can increase energy and feelings of pleasure through the release of dopamine in the brain, large amounts of alcohol have the opposite effect. Alcohol is a depressant. Excessive alcohol consumption causes drowsiness through the stimulation of a different neurochemical pathway (the GABA pathway) in the brain.
Naltrexone prevents endorphins from binding to the receptors in the brain when you drink alcohol. So instead of the short-term pleasure you feel when you drink caused by alcohol-stimulated endorphins and dopamine, you will feel less reward or pleasure after drinking alcohol with naltrexone.
Without any special feeling, you start to crave alcohol less. This helps you reduce the amount you drink, and some people are even able to stop drinking altogether with the help of naltrexone.
Is Naltrexone Habit-Forming?
One of the most significant advantages of using naltrexone to reduce alcohol consumption is that naltrexone itself is not habit-forming. This means people can safely start and stop naltrexone without experiencing withdrawal symptoms of the medication. While there are many types of prescription drugs that can be habit-forming, when it comes to this prescription medication to stop drinking, naltrexone addiction is not something you have to worry about.
Does Naltrexone have Side Effects?
As with any medication, naltrexone has the possibility of causing some side effects. However, if side effects occur it is likely that they can be mitigated by adjusting when you take your medication, your dosage, and other controllable factors. Your physician can walk you through your options. The most common side effects of naltrexone are nausea and headache. During clinical trials, there were no cases in which patients stopped taking naltrexone because side effects were too severe.
Is Naltrexone Safe For Everyone?
Is naltrexone safe for everyone? Most people can take naltrexone, except for people with specific co-occurring medical conditions. Everyone should consult with a physician before taking naltrexone, and people with a history of liver disease should disclose this to their treatment provider before taking naltrexone because a high dose can be toxic to the liver.
To learn more valuable information about the effects of naltrexone treatment, check out our blog that explains what drinking on naltrexone is like.
Can People Abuse Naltrexone?
Per the National Institute of Alcohol Abuse and Alcoholism, naltrexone “is not habit forming or a drug of abuse. It does not cause users to become physically or psychologically dependent.” Naltrexone is a non-controlled substance. Unlike controlled substances, which are more closely regulated by the government, naltrexone does not pose a risk of dependence. Naltrexone doesn’t produce the high or euphoria that may bee associated with other drugs used to treat substance use disorders, such as methadone or suboxone.
While naltrexone is very low risk in terms of misuse, it can only be prescribed by a licensed physician. At Monument, you’ll meet with a physician to see if naltrexone is safe and appropriate for you.
Can You Overdose on Naltrexone?
Overdosing on naltrexone is extremely rare. Naltrexone-related overdose is primarily caused by using opioids while also taking naltrexone. This can have potentially deadly consequences.
That’s why it’s necessary to speak with a healthcare provider, share honestly about your health history, and follow any instructions about how and when to take naltrexone. In most cases, naltrexone is taken as a one-time a day medication in the form of a 50-mg pill. In some cases, naltrexone is taken only prior to consuming an alcoholic beverage, as part of The Sinclair Method.
Is Naltrexone Right for Me?
Naltrexone is a great tool for many people who are looking to change the way they consume alcohol, especially when paired with online alcohol therapy and a supportive community. Many clinical studies support this, and it’s important people know about this option. Alcohol use disorder is a medical condition, and can be treated effectively with a medical solution.
That’s why the Monument approach includes medication, like naltrexone, as a tool in your treatment toolkit.
How Do I Get a Naltrexone Prescription?
Naltrexone requires a prescription from a licensed physician. Some in-person primary care physicians prescribe naltrexone, while others don’t prescribe it due to a lack of familiarity. At Monument, you can meet via video call with a qualified physician highly experienced in prescribing medication to stop drinking. If your physician deems naltrexone safe and appropriate for you, they will write you a prescription. Then, you can get your medication delivered directly to your door.
If you’re interested in learning more about how naltrexone can work for you, we encourage you to join the Monument Community where you can hear about naltrexone experiences from other members. We can also connect you to a licensed physician as part of our alcohol treatment program to discuss your options.
If you decide medication isn’t for you, you can explore other treatment options like support groups and a personalized alcohol treatment program. We’ll work with you to customize a plan that aligns with your preferences and lifestyle, and helps you reach your goals for sobriety or moderation. You can do this!
- The New England Journal of Medicine. “Naltrexone for the Management of Alcohol Dependence, https://www.nejm.org/doi/10.1056/NEJMct0801733?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed.” Accessed Dec, 10. 2020.
- SAMHSA. “Chapter 4—Oral Naltrexone, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565602/.” Accessed Dec, 10. 2020.
- NIAAA. “Naltrexone, https://www.ncbi.nlm.nih.gov/books/NBK64042/.” Accessed Dec, 10. 2020.
- University of Munich. “Opioid antagonists for alcohol dependence, https://pubs.niaaa.nih.gov/publications/combine/faqs.htm.” Accessed Dec, 10. 2020.
- National Library of Medicine. “A Systematic Review of Naltrexone for Attenuating Alcohol Consumption in Women with Alcohol Use Disorders, https://pubmed.ncbi.nlm.nih.gov/21154349/.” Accessed Dec, 10. 2020.
- Psychiatry. “The COMBINE Study, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945872/.” Accessed Dec, 10. 2020.
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