Naltrexone for Addiction Treatment and Rehab
If you or someone you care about is ready to make a change and overcome drug or alcohol addiction, finding a rehab program that includes naltrexone treatment can be a beneficial first step.
This article will discuss what naltrexone is, how it helps with drug and alcohol cravings, the benefits of naltrexone treatment, and the side effects of naltrexone. We will also talk about how to get naltrexone, rehab settings that use naltrexone for addiction, and how to find a naltrexone treatment center.
What Is Naltrexone?
Naltrexone is a type of medication known as an opioid antagonist.1,2 Naltrexone may be taken daily in pill-form, but it is also available as an extended-release, monthly injection (Vivitrol).1
Does Naltrexone Help with Drug or Alcohol Cravings?
By blocking some of the pleasurable or rewarding effects associated with opioid and alcohol use, naltrexone works to reduce cravings and lower the desire to continue using these substances.1
For individuals struggling with drug or alcohol cravings, naltrexone can be an effective treatment option to help them maintain abstinence in recovery.
What Does Naltrexone Do?
Naltrexone may be used in programs that utilize medications for addiction treatment. Sometimes referred to as “MAT,” the use of medications to treat addiction are typically combined with a form of behavioral counseling or therapy.1 In addition to naltrexone, other medications for addiction treatment may:1,2
- Decrease compulsive drug use behaviors.
- Reduce cravings for the substance.
- Relieve the discomfort of withdrawal when the drug of misuse is not available (e.g., opioid agonist medications, discussed below).
MAT does not substitute one addictive substance for another. It is part of a useful treatment plan that, for many individuals, has revolutionized addiction recovery. Medications can be effective in treating substance use disorders without creating a new addiction when used as directed. In fact, in the case of an opioid antagonist such as naltrexone, there is no risk of either physical dependence or addiction to the treatment drug.1
Naltrexone is just one of the primary medications used to treat opioid and alcohol addiction. In opioid treatment, methadone and buprenorphine are other commonly used medications.3
- Methadone is a long-acting, full opioid agonist.3 This means that it triggers opioid receptors in the brain, minimizing withdrawal symptoms and cravings, but also (when carefully dosed) avoids the pitfall of providing an intensely rewarding high similar to those experienced with misused opioids.
- Buprenorphine (available in combination with naloxone under the trade name Suboxone) is a partial opioid agonist.3,4 This means that it also triggers the same opioid receptors, but to a lesser extent than a full agonist, resulting in less potential for euphoria and sedation. As a partial agonist, buprenorphine also has an upper limit, or ceiling to its potentially rewarding opioid effects, which further discourages attempts to misuse the treatment drug.
Naltrexone works differently than these opioid agonist options. Rather than activate the opioid receptors in the body, naltrexone blocks these receptors from being activated. While someone on naltrexone, they will not experience the desired, rewarding effects from opioid or alcohol use, thus discouraging continued, problematic use of these substances.1
Benefits of Naltrexone Treatment
Compared to other forms of addiction treatment medications for opioid and alcohol addiction, naltrexone holds many benefits. It is a desirable addiction medication because naltrexone:1,2
- Can be a safe and effective component of both alcohol and opioid use disorder treatment.
- Is not addictive, nor does it lead to physiological dependence. Someone can end use at any time without withdrawal symptoms.
- Does not create a “high” or respiratory depression.
- Has a long-acting, monthly injectable option.
- Is an option for people interested in ending all opioid and/or alcohol use.
Can Naltrexone Help with Drug and Alcohol Withdrawal?
Naltrexone treatment is often started after the signs and symptoms of acute alcohol and opioid withdrawal have resolved—roughly 3 to 7 days after the last drink, in the case of alcohol, and one to two weeks after last opioid use (depending on the opioid having been previously misused).1,5
If a person begins using naltrexone before completion of an opioid detox, they may be at heightened risk of opioid withdrawal symptoms.1
Naltrexone must be used consistently to obtain the desired results. The oral treatment option must be taken daily. Without proper adherence to a prescribed treatment regimen, the medication loses its effectiveness.1,2
Side Effects of Naltrexone Treatment
As with many prescription medications, naltrexone use may be accompanied with certain side effects, including:1,5
Despite its limitations and side effects, naltrexone remains a useful therapeutic agent for the management of alcohol or opioid addiction.
How to Get Naltrexone
Before someone can begin treatment with naltrexone, they will be screened and assessed as appropriate candidates. Individuals who may benefit from naltrexone treatment:1,2,5
- Have already detoxed from opioids and alcohol.
- Are motivated to maintain recovery and abstain from all opioids and alcohol.
- Remain at risk for relapse without treatment.
- Are currently using other medications for addiction treatment, but are considering switching to, or adding naltrexone treatment.
Once it is established that an individual is a good candidate for naltrexone, treatment can begin. Frequently, someone will enter treatment while still using alcohol and/or opioids. In this case, the process takes several steps, with a naltrexone treatment protocol that typically includes:1,2,5
- Evaluating the needs of the individual during intake.
- A toxicology screening (blood, breath, or urine) to determine current substance levels in the patient’s body.
- Detox from alcohol and opioids.
- A physical exam to identify any medical issues (such as liver disease) that could be complicated by naltrexone use.
Rehab Settings that Use Naltrexone for Addiction
Naltrexone treatment can be initiated in both inpatient and outpatient settings at rehab facilities or clinics. The stage of treatment at which naltrexone treatment is started may differ depending on previous treatment progress and ultimate recovery goals of the person seeking to end their alcohol or opioid use.
Inpatient Naltrexone Treatment
Inpatient treatment offers a safe, supportive environment with 24-hour staffing and care from medical providers. The individual lives at the treatment center, usually for a predetermined amount of time.6,7
This setting is beneficial for treating people with significant alcohol and/or opioid dependence because it facilitates a week or more of initial opioid detox and withdrawal management, as well as the safe and comfortable alcohol withdrawal management period prior to initiation of naltrexone therapy.2,3
Detox and medically managed withdrawal will be the emphasis during the early days to weeks of treatment, with a later shift toward maintaining sobriety. Staff will provide observation, treatment, and encouragement to maintain the treatment plan.
Inpatient treatment programs will vary in duration. Some last for a few days, while others can several months, or more as needed.6,7
Outpatient Naltrexone Treatment
Another treatment option is outpatient naltrexone treatment. Unlike inpatient programs, the individual participating in outpatient treatment while taking naltrexone may visit a treatment center or provider office during the day to participates in counseling and other therapeutic activities, while having their progress on naltrexone therapy assessed regularly.
Outpatient treatment options are ideal for people who have work or family responsibilities that require them to be at home, however it is very important that people in outpatient treatment programs have a strong, stable support system in place to aid in their recovery.6,7
Naltrexone and Addiction Aftercare
People can take naltrexone for well beyond the initial rehabilitation period. Because of this, naltrexone may continue to be used as a person follows an aftercare plan for relapse prevention and sustained recovery. Various outlets for aftercare services include regularly scheduled counseling with a therapist or other addiction treatment practitioners, as well as frequent attendance of mutual support group meetings such as Alcoholics Anonymous and Narcotics Anonymous.
Behavioral Therapy and Naltrexone for Drug and Alcohol Addiction
Behavioral therapy is a cornerstone of comprehensive addiction treatment. Several therapeutic styles have proven effective when combined with naltrexone. People who use both medication and psychotherapy have longer periods of abstinence than people with medication only.2 Some common therapy options are:2,6,7
- Cognitive behavioral therapy (CBT). This therapy style strives to improve how a person identifies and manages unwanted behaviors through enhancing self-control and coping skills. Cognitive behavioral therapy is effective for many substance use disorders as well as co-occurring mental health conditions.
- Contingency management (CM). Based on the notion of using external rewards to counteract the physical “rewards” of substance use (i.e., feelings of euphoria, etc.), CM provides tangible reinforcement in the form of prizes, tickets, and money when participants complete healthy, substance-free behaviors.
People may also choose to participate in support groups such as 12-Step programs or SMART Recovery to complement their professional treatment during aftercare.2,6,7
What Are Naltrexone Implants?
Naltrexone implants are small pellet forms of the drug surgically inserted under the skin that slowly release the medication over varying lengths of time.8
While it has been used in Europe and Australia for alcohol and drug addiction treatment, the implantable version of naltrexone has not yet been approved by the U.S. Food and Drug Administration (FDA) for use in the U.S.8
Only oral tablet and injection forms of naltrexone are currently used in the U.S. for treating opioid dependence.
Finding a Naltrexone Treatment Center
Both traveling for naltrexone treatment and staying near home have potential benefits and drawbacks. If you want to stay near family or with a supportive network of friends, a local program may be a good option. You can call us at or use our local rehab finder directory to help find a facility near you.
If you don’t have the desired level of support at home or want to make a fresh start somewhere new, traveling for treatment may provide a more appropriate setting for recovery. Travel is likely to add to the cost of treatment, but if it will help you get and stay sober, it can be well worth it.
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