Naltrexone: What It Is and How to Use It Safely

Naltrexone is a prescription medication used to reduce cravings and prevent relapse in people with alcohol use disorder and opioid dependence. It works by blocking opioid receptors in the brain so alcohol or opioid use gives little or no reward. Because it removes the reinforcing effect, many people find it easier to stay sober while taking naltrexone.

How naltrexone is used

There are two common forms: oral naltrexone, usually 50 mg once daily, and a long-acting injectable (often called Vivitrol) given as 380 mg once a month. For alcohol treatment the pill can be started soon after drinking stops. For opioid dependence you must be opioid-free first - typically at least 7-10 days after short-acting opioids or longer after long-acting ones - otherwise naltrexone can trigger sudden withdrawal. Doctors choose the form based on lifestyle, adherence, and medical status.

There's also an off-label low-dose approach where clinicians prescribe tiny doses (for example 1.5-4.5 mg) for chronic pain or certain autoimmune issues. Evidence for low-dose naltrexone is limited and mixed, so discuss benefits and risks with a clinician before trying it.

Practical safety tips

Before starting a prescription, expect a baseline liver test. Naltrexone can stress the liver in high doses or when liver disease exists. Common side effects include nausea, headache, fatigue, sleep problems and vivid dreams. These often ease after a few days but report severe abdominal pain or jaundice right away.

Never take naltrexone while you still need opioids for pain relief. If you do need emergency surgery or strong pain medication while on naltrexone, tell medical staff - opioids may not work and alternative pain plans are needed. Also avoid buying naltrexone from unverified online sellers. Get it through a licensed pharmacy with a valid prescription and pharmacist support.

If you're pregnant, breastfeeding, or have active hepatitis, talk candidly with your clinician. Special situations need personalized advice. Naltrexone is one tool, not a standalone cure. Combining medication with counseling, mutual-help groups, and a support plan gives the best chance of lasting benefit.

Finally, small practical ideas make treatment smoother. Use a weekly pill box or calendar reminders for the oral form. If injection is chosen, book monthly appointments ahead of time and bring a trusted person to follow up. Keep emergency contacts listed and wear medical ID if you've had recent opioid dependence so first responders know your history.

Naltrexone does not cause dependence and does not make you high. It can reduce heavy drinking quickly - clinical trials show fewer heavy drinking days and lower relapse risk when combined with counseling. It interacts with opioid medicines: avoid opioid cough syrups, codeine, tramadol, methadone, buprenorphine; starting naltrexone while addicted to opioids causes fast withdrawal. Tell dentists and emergency teams before procedures. People taking psychiatric meds should inform their prescriber, but most antidepressants are safe with naltrexone. If you run into trouble getting a prescription, ask addiction clinics or your GP; many public programs can help cover costs.