Naltrexone is a drug that physicians can effectively utilize to help individuals who are suffering from drug and alcohol addictions. It is especially effective at treating the symptoms of opioid use disorder and alcohol use disorder, though cutting-edge research is beginning to demonstrate potential for treating other substance addictions as well. Naltrexone treatment is an important part of many treatment plans offered by outpatient rehabs. However, the medication is most effective when it is part of a medication-assisted treatment (MAT) plan.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment, also known as MAT, is a clinically effective type of treatment for substance use disorders. This evidence-based modality combines two different methods simultaneously: medication and behavioral therapy. While the term “medication” may make one assume that the treatment method involves medication is alone, the reality is more nuanced. In fact, medication-assisted treatment actually emphasizes group therapy and individual therapy far more than medications. In a MAT plan, doctors prescribe medications to help clients obtain maximal benefits from behavioral therapies.
What do medications accomplish during medication-assisted treatment? Prescription drugs can help people deal with addiction in many ways. Some drugs reduce withdrawal symptoms, making it easier for clients to wean off of recreational drugs. Other medications reduce cravings. Others protect from relapse by reducing the dangers. Some drugs limit the pleasurable effects of recreational substances, and thereby discourage people from abusing them. Many medications have more than one of the above-listed benefits, including naltrexone.
What is Naltrexone?
Naltrexone, which is often sold under the brand names Vivitrol and ReVia, is a clinically effective medication that can be utilized to treat opioid addiction and alcohol addiction. It is most commonly administered in the form of an oral tablet, though formulations of naltrexone that are administered through an intramuscular injection are also available. When injected, clients usually take naltrexone only once a month.
Unlike many drugs used for opioid addiction, naltrexone cannot be taken by individuals who are still physically dependent on opiates. It is crucial for clients to fully withdraw from opioids before they can take naltrexone. Physicians are free to prescribe the medication after their clients are fully opioid-free. This process can take 7 days at a minimum, though waiting 10 days is often ideal. If a client takes naltrexone before they have fully withdrawn, the medication can cause severe opioid withdrawal symptoms.
How does naltrexone work? When a person takes naltrexone, the drug binds to opioid receptors in the brain. Instead of activating them, however, naltrexone blocks these receptors. It thereby makes it more difficult for these receptors to be activated. This means that when a person takes a recreational substance that normally causes opioid receptors to release dopamine and endorphins, the recreational substance will have almost no effect.
When a person who is taking naltrexone relapses, they will not get high. Moreover, they are unlikely to experience the most severe dangers of relapsing, such as intoxication and overdose. Because naltrexone prevents people from getting high, it makes relapse significantly less appealing. It also protects people and reduces mortality rates, even among people who do relapse.
As such, naltrexone is an important part of many recovery plans at outpatient rehab centers. After a client has withdrawn from their drug of choice, taking naltrexone can help them stay sober and committed to their program of recovery. By reducing the likelihood of relapse, naltrexone ensures that clients can get through the most critical periods of early sobriety. During this time, they can take part in behavioral therapies, work to develop essential coping tools, and build the sober social support systems they need for long-term sobriety.
Side Effects of Naltrexone
Most people who take naltrexone experience few negative side effects, if any. Nonetheless, it is important to recognize that naltrexone is a powerful opioid drug that must be taken as prescribed. Even individuals who take naltrexone properly under medical supervision sometimes experience some side effects. These can include:
- Upset stomach
- Exhaustion or sleep issues
- Restlessness or nervousness
- Muscle pain or joint pain
- Decreased appetite
When naltrexone is taken in the form of an injection, some people sometimes experience an allergic reaction. Allergic reactions can come in the form of acute liver toxicity. Some people experience eosinophilic pneumonia. Fortunately, these allergic reactions are quite rare. For most people, naltrexone treatment is well-tolerated and side-effect-free. Even when there are a few uncomfortable side effects, they are usually balanced out by naltrexone’s many benefits.
Naltrexone for Alcohol Use Disorder
Naltrexone was originally approved by the Food and Drug Administration in 2006 as a medication for treating acute alcohol dependence. Taking naltrexone can reduce the likelihood of relapsing on alcohol. While many drugs serve this purpose, including disulfiram, they work a bit differently. Disulfiram, for instance, causes people to experience uncomfortable — even painful — symptoms when they drink alcoholic beverages. Naltrexone stands out because it simply makes alcohol ineffective, and therefore less appealing.
Naltrexone treatment is clinically effective, and there is a large body of research confirming the efficacy of this form of medication-assisted treatment. When naltrexone and behavioral therapy are utilized together, rehab graduates have 25% fewer incidents of heavy drinking than those who used placebos. Making use of naltrexone and behavioral therapy in the context of a MAT plan leads to higher rates of abstinence, lower rates of relapse, and reduced mortality rates.
The reason why naltrexone is effective for alcohol use disorder is poorly understand. Naltrexone’s primary effect on the brain is blocking opioid receptors. While alcohol is not an opiate, researchers believe that opioid receptors do play a role in the euphoria people experience while drinking alcohol. These receptors, when activated, release large quantities of dopamine and endorphins, neurotransmitters that reinforce addictive behaviors and cause euphoria. By blocking these receptors and preventing these neurotransmitters from being released, naltrexone makes alcohol less pleasurable.
Naltrexone for Opioid Use Disorder
Naltrexone was originally developed to treat alcohol use disorder, but physicians prescribed it off-label to treat opioid dependence for a long time. By 2010, naltrexone was granted official approval by the FDA for treating opioid use disorder. This was after multiple studies emerged that demonstrated the drug’s usefulness. These studies showed that people taking naltrexone were more likely to remain enrolled in rehab. By increasing rehab retention rates and reducing the likelihood that a person will drop out of their treatment program, naltrexone helps people develop the essential coping skills they need to maintain long-term sobriety.
Naltrexone may be clinically important when it comes to reducing the possibility of relapse, but it is not designed to assist with opioid withdrawal. While some MAT drugs, like methadone and buprenorphine, are designed to assist with withdrawal by replacing the recreational drug, naltrexone cannot be taken until a client is fully withdrawn from opiates. If opioids are present in the body and a person takes naltrexone, they will immediately experience acute withdrawal symptoms. As such, naltrexone cannot be combined with other opioid MAT medications, such as buprenorphine, Suboxone, and methadone.
The mechanism of action of naltrexone is better understood when it comes to opioid dependence. The medication works by blocking opioid receptors. While these receptors play a role in alcohol intoxication, they play an essential role in opioid intoxication. When naltrexone blocks these receptors, it becomes physically impossible for a person to get high on recreational opioids. As such, naltrexone is far more clinically effective for opioid addiction than for alcohol addiction.
One study showed that taking naltrexone causes patients to remain 90% opioid-free. This is more than double that 35% rate achieved by placebo medications. Researchers also conclude that engaging in medication-assisted treatment with naltrexone makes a person 17 times more likely to stay opioid-free over the long run.
Naltrexone for Crystal Meth Addiction
While naltrexone is primarily indicated as a medication for alcohol addiction and opioid addiction, the drug has shown promise in treating other addictions as well. Recent studies have demonstrated that naltrexone may have some benefits when it comes to recovering from methamphetamine addiction. When combined with oral bupropion, naltrexone reduces crystal meth cravings and makes the drug significantly less pleasurable to recreational abusers. These studies have indicated that naltrexone may have similar effects for other central nervous stimulants aside from meth, including amphetamine drugs, cocaine, and crack. Some rehabs have begun experimenting with incorporating naltrexone into a wider variety of MAT plans.
Naltrexone Treatment at NuView Treatment Center
NuView Treatment Center, an outpatient rehab located in West LA, works to assist individuals suffering from substance use disorders and comorbid mental health disorders. We work with people suffering from all severities of drug and alcohol use disorders. Our modern facility, which employs on-site physicians and masters-level clinicians, offers a diverse array of evidence-based treatment modalities, ranging from group therapy and skills training to medication-assisted treatment with naltrexone.
Our philosophy is that a whole-person-centered approach to treatment is critical to successful recovery. Our clinicians are committed to developing individualized treatment plans, never one-size-fits-all approaches. Every client who walks through our doors has a unique story, unique needs, and unique goals. Individualized and holistic treatment plans help them address their specific underlying issues and work toward their personal goals in recovery.
We work with people suffering from mental illness and addiction at all severities. At NuView Treatment Center, we offer the following levels of outpatient care:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
If you or a loved one is suffering from alcohol or opioid use disorder, there is no reason to suffer alone. Reach out to NuView Treatment Center today to schedule a free and confidential consultation.