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Naltrexone and Alcohol

What is Naltrexone? 

Intramuscular extended-release Naltrexone is a prescription drug approved by the Food and Drug Administration (FDA) as a medication-assisted treatment (MAT) option for both opioid withdrawal symptoms and addiction treatment and alcoholism treatment. Vivitrol is the brand name of Naltrexone. Vivitrol shot can be used to help people maintain abstinence while recovering from alcohol use disorder or heroin addiction. While naltrexone hydrochloride is for both daily and once-a-month dosages, Vivitrol is injected once a month.

Naltrexone (Vivitrol) can be prescribed and administered by any medical practitioner licensed to prescribe medications. It is available in a pill form for alcohol use disorder or as an extended-release intramuscular injectable for either alcohol or opioid use disorder. A Risk Evaluation and Mitigation Strategy (REMS) is required for the long-acting injectable formulation to ensure that the benefits of the prescription drug outweigh its risks. The pill form can be taken daily for alcoholism treatment, but the extended-release injectable formulation is only approved for opioid or heroin addiction treatment[1]. The pill form is taken daily and the extended-release injectable is administered every four weeks, or once a month, by a medical practitioner.

Naltrexone and Alcohol
Naltrexone is considered to have no abuse potential and does not result in the development of physical dependence. Unfortunately, if you combine Naltrexone and alcohol, you may experience extreme side effects of drinking.

How Naltrexone Works

Naltrexone functions by blocking the effect that opioids, such as heroin or opioid prescription drugs, have on the brain. It reduces the cravings that many individuals experience after they quit. With alcohol, it is not certain how Naltrexone actually works, but it seems to change how the brain responds to alcohol consumption. Is it possible to become addicted to naltrexone? No. Naltrexone is not habit-forming or a drug of abuse. In addition, it does not cause users to become physically or psychologically dependent [2]. 

It is important to note that Naltrexone does not treat withdrawal symptoms; rather, it is designed to suppress cravings for alcohol or opiate drugs. People with moderate to severe alcohol use disorders who are using naltrexone may experience withdrawal symptoms if they stop drinking that can be potentially fatal due to the development of seizures. These individuals should consult with an addiction medicine physician or psychiatrist before discontinuing their use of alcohol.

Naltrexone and Alcohol Use

Naltrexone is a pure opiate antagonist and blocks opiate receptors in the body. It is approved to treat patients with opioid use disorder (OUD) or alcohol use disorder, along with a medically-supervised behavior modification program. It is not an opioid and does not cause euphoria (a “high”) or withdrawal symptoms when you stop it.

Can you still get drunk on naltrexone? While naltrexone may block the feelings of intoxication (the “buzz”) from alcohol, it does not block the impairment you might have, such as reduced coordination or reflexes, or poor judgment. Even though you may not feel drunk, this can make driving or other activities dangerous. You may still suffer a loss of motor coordination, decreased response time, and slowed rates of thinking.

Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol. Studies support the notion that naltrexone (Vivitrol) effectively reduces alcohol intake but is not effective in promoting abstinence from alcohol. Individuals in these studies often continued to drink alcohol while on naltrexone, and there were no significant or dangerous effects noted.

What to Avoid When Taking Naltrexone

Like most medications, Naltrexone can interact with other substances and cause severe side effects. Because Naltrexone is used to treat alcohol and opioid addiction, individuals are advised to avoid these substances during treatment.

The following medications can adversely interact with Naltrexone:

  • Disulfiram
  • Diarrhea medications
  • Cough medications
  • Codeine
  • Hydrocodone
  • Oxycodone
  • Morphine

Naltrexone and Alcohol Interaction

Naltrexone may cause liver problems, and using it with other medications that can also affect the liver such as ethanol may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications.

Side Effects of Naltrexone and Alcohol

Common side effects of naltrexone and alcohol may include:

  • Nausea
  • Sleepiness
  • Headache
  • Dizziness
  • Vomiting
  • Decreased appetite
  • Painful joints
  • Muscle cramps
  • Cold symptoms
  • Trouble sleeping
  • Toothache

Severe reactions of the body to the mixed Naltrexone and alcohol as well as at the site of injection. Severe injection site reactions are possible, including tissue death. Some of these reactions have required surgery. Patients should call their practitioner right away if they experience any of the following issues of concern at the injection site:

  • Intense pain
  • The area feels hard
  • A large area of swelling
  • Lumps
  • Blisters
  • An open wound
  • A dark scab

Patients should contact their practitioner about any reaction at an injection site that is concerning, gets worse over time, or does not get better within two weeks. Liver damage or alcoholic hepatitis is possible with Naltrexone and alcohol. Patients should tell their practitioner about any of the following symptoms during treatment:

  • Stomach area pain lasting more than a few days
  • Dark urine
  • Yellowing of the whites of your eyes
  • Tiredness

Practitioners may need to stop treatment using naltrexone if patients develop signs or symptoms of a serious liver problem

Other side effects include:

  • Depressed mood
  • Pneumonia
  • Serious allergic reactions
    • Skin rash
    • Swelling of face, eyes, mouth, or tongue
    • Trouble breathing or wheezing
    • Chest pain
    • Feeling dizzy or faint

Naltrexone and Alcohol Withdrawal 

Naltrexone will help you avoid using alcohol, but it will not prevent or relieve the alcohol withdrawal symptoms that may happen when you quit drinking alcohol. Instead, naltrexone may cause or worsen alcohol withdrawal symptoms. You should not take this medication if you have recently stopped using opioid medications or opioid street drugs and are now experiencing opioid withdrawal symptoms.

People who overuse drugs or alcohol often become depressed and sometimes try to harm or kill themselves. Receiving naltrexone does not decrease the risk of self-harm or suicide. You or your family should call the doctor right away if you experience symptoms of depression such as feelings of sadness, hopelessness, anxiousness, guilt, worthlessness, helplessness, or thinking about harming or killing yourself or planning or trying to do so. Be sure that your loved one knows which symptoms may be serious so they can call the doctor right away if you are unable to seek treatment on your own.

Naltrexone and Alcohol
Naltrexone and alcohol treatment has helped augment recovery from addiction to alcohol. Treatment managed with both Naltrexone and rehabilitation counseling spent more time abstinent from alcohol and had lower relapse rates

Naltrexone and Alcohol Consumption

Alcohol addiction claims the lives of thousands of Americans each year and affects millions more. Alcohol use disorder (AUD), commonly known as alcoholism is mental health and medical condition in which individuals find it hard to stop or manage their alcohol use despite social, occupational, or health repercussions. According to the National Institute of Mental Health (NIMH), alcohol use disorder is classified as a chronic, relapsing mental disorder that can vary in severity. It causes long-term alterations in the brain, perpetuating the condition and making people vulnerable to a relapse. Fortunately, many evidence-based treatments and medications are available to help individuals with an AUD achieve and maintain sobriety, regardless of its severity.

Treatment for alcohol use disorders often involves abstinence-only based approaches. However, some individuals can benefit from treatment even while still using it. One such alternative treatment involves a medication called naltrexone, which allows individuals to gradually reduce their heavy drinking habits.

Naltrexone and Alcohol Treatment

Therapeutic options for alcohol dependence and addiction range from brief interventions (such as education and counseling) performed by health care professionals through specialty counseling programs to drug therapies for more severe or chronic dependence. The Food and Drug Administration (FDA) has approved several medications to treat alcohol dependence, including acamprosate, disulfiram, and naltrexone.

The ideal patient for naltrexone therapy would be a person who has moderate-to-severe alcohol dependence — for instance, an individual who drinks more than 50% of the day, consumes more than five drinks a day and has alcohol-related problems. Such a person has probably failed in attempts to quit drinking but has a relatively high motivation to be abstinent or at least to try abstinence for a while.

A good indication of this motivation is the ability to abstain from drinking for several days before starting naltrexone. The patient should always be asked to attempt to abstain for several days or be withdrawn from alcohol with medical assistance (benzodiazepines or anticonvulsants) before the drug is prescribed.,

Benefits of Naltrexone

Although Naltrexone has a lengthy history of success in treating alcohol use disorder, it is not sufficient when taken alone. Naltrexone does not reduce the cravings for alcohol, nor does it reduce the symptoms of alcohol withdrawal. Naltrexone is most effective when taken in concert with other forms of treatment, including other medications, therapy, counseling, and 12-step programs. One area where Naltrexone has proven especially useful is in the treatment of alcoholics who have relapsed.

If you are the one suffering from alcohol abuse, the first step is recognizing you need help. Many studies show that people struggling with alcohol abuse can benefit from some form of alcohol detox and inpatient treatment. However, everyone is different. Not all treatments work the same for every person. The sooner a person seeks treatment, the better the outcome.

Cognitive Behavioral Therapy can be used to treat alcohol abuse. Treatment can take the form of support groups, counseling, or a combination of the two. In addition, some prescription medicines can treat alcohol abuse by helping people stop or reduce their drinking. However, as with all drugs, some might cause side effects.

Once you have found an effective treatment, it’s essential to stick to that treatment. Also, it’s helpful to avoid situations that involve a lot of alcohol. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists here at We Level Up to learn the interaction of naltrexone and alcohol, and if it could be your best option for medically-assisted treatment. Your call is private and confidential, and there is never any obligation.

Naltrexone and Alcohol
After receiving naltrexone, your body will be more sensitive to opioids if you use opioid medicine in the future. Using the same amount you used before could lead to overdose or death.
Sources

[1] SAMHSA – https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone

[2] NIAAA – https://pubs.niaaa.nih.gov/publications/combine/faqs.htm

[3] NIH – https://medlineplus.gov/druginfo/meds/a685041.html