Key Highlights

  • Naltrexone is a prescription medication often used to help manage dependence on substances like alcohol and opioids. It works by blocking opioid receptors in the brain. This reduces cravings and prevents euphoria associated with substance use.
  • You can feel the effects of oral naltrexone within an hour. Healthcare providers may ensure you’re opioid-free before initiating therapy, as naltrexone can precipitate withdrawal.
  • Side effects are generally more pronounced during an initial withdrawal phase from the substance being managed if naltrexone is used during this time. If naltrexone is continued long-term, it’s generally well-tolerated when used as prescribed.
  • Naltrexone can help a lot with your recovery. However, combining it with therapy or support groups is good for a better chance of success.

Introduction

Substance use disorders are common, and their effects can be devastating. However, treatment is available and can help people regain control of their lives. Naltrexone has become established as a helpful tool for individuals concerned about their use of substances like alcohol and opioids. Keep in mind that this guide is general, and your own experience may vary. Talking to your healthcare provider about a treatment plan that fits your needs is very important.

Understanding Naltrexone and Its Purpose

Naltrexone is a prescription medication often used to help people manage alcohol or opioid use problems. Unlike some alternatives, it doesn’t replace the addictive substance. Instead, it works by affecting the brain's reward system. Naltrexone is used to block the opioid receptors in the brain.

This prevents these receptors from being activated by opioids or alcohol. As a result, it reduces the feelings of pleasure and intense cravings that individuals often experience when using these substances. Consequently, people using naltrexone typically notice a significant decrease in their urges.

Defining Naltrexone and Its Role in Addiction Treatment

Naltrexone is recognized as an opioid antagonist, which means it blocks opioid and endorphin receptors in the brain. By doing so, it reduces the feelings of euphoria associated with opioids like heroin and prescription painkillers. This mechanism helps combat opioid dependence by diminishing the rewards that fuel addiction.

When naltrexone is used during the early stages of opioid withdrawal, it’s typically used at low doses and combined with other medications (e.g., buprenorphine or clonidine). If naltrexone is used alone, it can precipitate unpleasant and potentially dangerous withdrawal symptoms. In some cases, a test may be performed to confirm an individual is opioid-free before starting naltrexone. This can be accomplished by using a naloxone challenge.

Naltrexone is also helpful for treating alcohol dependence, although it seems to work a bit differently for this purpose. Evidence points to modifications of the hypothalamic-pituitary-adrenal axis, which ultimately can help slow down alcohol cravings.

The Science Behind Naltrexone: How It Affects the Brain

Opioid receptors are primarily located in the brain's reward pathway. They play a crucial role in our experience of pleasure and rewards. When opioids or alcohol enter the body, they bind to these receptors. This binding triggers the release of dopamine, often referred to as the “feel-good” chemical.

Naltrexone works like a shield for these opioid receptors. It attaches to the receptors without activating them, preventing dopamine from being released.

What Happens When You Start Taking Naltrexone

Naltrexone is always considered one piece of the puzzle when approaching addiction management. While it can be the only medication used in some instances, it’s also often paired with other medications. Therapy and support from family, friends, and community groups are highly beneficial. The approach can also vary depending on individual needs.

Opioid Withdrawal

When opioid use is stopped after an extended period of consistent use, withdrawal symptoms can occur. These can be highly unpleasant and, in some cases, dangerous. The potential symptoms of withdrawal include:

  • Nausea
  • Vomiting
  • Sweating
  • Dilated pupils
  • Muscle pain

The onset of symptoms and the amount of time spent in withdrawal varies depending on the type of opioid that was used. Heroin has a very short half-life, so withdrawal symptoms occur more quickly, and the substance is cleared from the body more rapidly. Prescription opioid painkillers are sometimes released over extended periods. In these cases, withdrawal symptoms take longer to appear, and the drug takes longer to be cleared from the body.

It’s often recommended to be free from opioids (including tramadol) for at least 7 to 10 days before starting naltrexone because it can cause withdrawal symptoms to become more intense. Because of this, if naltrexone is considered during the withdrawal stage, it’s likely to be prescribed at a lower dose and combined with other medications like buprenorphine or clonidine to help lessen the impact of withdrawal symptoms.

Naltrexone is sometimes prescribed on a continuous, ongoing basis to help provide long-term support for managing cravings associated with opioid use disorder.

Long-Term Management of Opioid Use Disorder

When naltrexone is used long-term to help manage cravings, it’s often started at a relatively low dose (e.g., 25 mg daily) for a few days before being increased. Target doses vary depending on individual needs, preferences, and the form of naltrexone provided.

Tablets can be taken:

  • 50 mg once daily
  • 100 mg every other day
  • 150 mg every 72 hours

Long-acting injectable forms of naltrexone are usually administered intramuscularly once per month.

Once the initial detox is complete and the maintenance phase is started, support is also highly beneficial for preventing relapse. This includes therapy and support from family, friends, and community members (e.g., peer support groups).

Alcohol Use Disorder

Similar to opioids, it’s also recommended to stop drinking before starting naltrexone. Depending on individual needs, this can sometimes be accomplished independently. Medical support is also helpful in managing the initial symptoms of alcohol withdrawal. Treatment usually involves benzodiazepines or anticonvulsants for initial withdrawal, and naltrexone is reserved for longer-term support once initial stability is achieved.

Once you’re alcohol-free, naltrexone can be started for longer-term support. Like opioid use disorder, naltrexone for alcohol use disorder is usually started at a lower dose for several days (e.g., 25 mg daily). After that, the dose can be increased depending on individual needs, preferences, and the form used.

Tablets are often prescribed:

  • 50 mg once daily
  • 100 mg every other day
  • 150 mg every 72 hours

Long-acting injectable forms of naltrexone are usually administered intramuscularly once per month.

Side Effects of Naltrexone

For many individuals, some of the more difficult stages of therapy will have already passed by the time naltrexone is used consistently. However, symptoms of addiction like cravings tend to continue to linger long-term, and support from medications like naltrexone can be helpful.

Naltrexone is generally well-tolerated when used as prescribed. However, it’s important to be aware of some of the potential side effects. These include:

  • Headache
  • Nausea
  • Abdominal pain
  • Insomnia
  • Irritability

If any side effects are bothersome, seem to worsen, or linger over time, talk with your healthcare provider to ensure your current medication and dose are still the best option for you.

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The Role of Support Systems During Recovery

Having a strong support system is very important when adjusting and promoting stability. Whether it's family, friends, a therapist, or support groups, being around people who care about your healing journey can really help. They can offer:

  • Emotional Validation: They will help you know you are not alone in this.
  • Practical Assistance: They can assist with daily tasks if you face side effects.
  • Accountability: They provide gentle encouragement to keep you on your treatment plan.

Support groups, whether online or in person, can be particularly beneficial. These groups connect you with others who understand how to manage alcohol or opioid use disorders. Talking openly about your experiences, challenges, and successes can provide you with valuable insights, motivation, and a sense of community. Remember, seeking help demonstrates your strength and commitment to mental health and overall well-being.

Conclusion

Navigating addiction management can feel daunting, but it can be manageable with the right support. Stay connected with family, friends, and the community. If a medication is needed, naltrexone might be a helpful option for some patients. The time frame can vary depending on the substance being used and other individual factors. Naltrexone is often considered to support the long-term maintenance of sobriety.

Lastly when considering treatment options for addiction your genetics play a vital role in determining which medications will be best suited for you. A simple test can help reduce the trial and error process associated with finding the right medication. Find out more by visiting www.clarityxdna.com

Once the initial phases of withdrawal are complete, it becomes more critical to build long-term consistency and stability.

Frequently Asked Questions

How long should I wait to see the full effects of Naltrexone?

Naltrexone blocks opioid receptors in the body within an hour. This means effects like precipitated withdrawal can be pretty immediate if taken while still using substances like opioids. It’s critical to work closely with your healthcare providers and use the medication as intended—often for longer-term maintenance therapy.

Can Naltrexone be used for conditions other than addiction?

Yes. Healthcare providers sometimes recommend naltrexone for other conditions like cholestatic pruritus. It’s also sometimes used in combination with bupropion for managing obesity.

Is it safe to consume alcohol or opioids while on Naltrexone?

It is very important to stay away from alcohol use and illegal drugs or opioid drugs when you are taking naltrexone. Using substances while taking naltrexone can precipitate withdrawal.


References:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c67a22bb-d2bd-4da5-9d3e-6b5281f10891

https://www.ncbi.nlm.nih.gov/books/NBK534811/

https://www.ncbi.nlm.nih.gov/books/NBK526012/

https://pmc.ncbi.nlm.nih.gov/articles/PMC2565602/

https://clarityxdna.com/blog/genetic-testing-for-medication-efficacy/