Is Naltrexone Addictive?

If you’re considering going to treatment for an opioid or alcohol addiction, you may have heard that you’ll be given naltrexone. Sometimes this concerns people because they don’t want to beat one addiction, only to become addicted to another drug. However, naltrexone is not addictive and is a safe part of an overall substance abuse treatment plan.

What Is Naltrexone?

Naltrexone is an FDA-approved drug for the treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). It’s given in a daily pill for AUD, or in a monthly extended release injection form for AUD or OUD.

How Naltrexone Works

Naltrexone blocks opioid receptors in the brain, thus blocking the euphoric and sedative effects of opioids. It suppresses opioid cravings that can lead to relapse and is not addictive. Stopping its use does not lead to withdrawal symptoms.

Opioid Use Disorder and Naltrexone

The injectable form of naltrexone is used to treat OUD. It’s not given until withdrawal symptoms from the addiction are over. You should not use opioids or drink alcohol when on naltrexone and you should also ask your doctor about taking naltrexone with other medications that you take.

The most important thing to remember when being treated with naltrexone is that it will reduce your tolerance to opioids. If you use opioids while on naltrexone or shortly after discontinuing its use, you may take more opioids to get the desired effects, which can lead to overdose.

Signs of an opioid overdose include:

• Blue lips or fingernails
• Unresponsiveness
• Pinpoint pupils
• Slow, irregular, or stopped breathing
• Slow heartbeat
• Low blood pressure
• Pale, clammy skin

Using opioids while or after taking naltrexone comes with an increased risk of overdose, so you should let your friends and family know about the risks so that they are prepared.

Alcohol Use Disorder and Naltrexone

AUD can be treated with the daily naltrexone pill or the monthly injection. It’s not given until the alcohol detox process is complete. Naltrexone blocks the effects of alcohol, reducing cravings or the amount of alcohol that you consume. Its purpose is to help you maintain your sobriety and avoid relapse. It’s generally taken for three to four months after stopping drinking.

Side Effects of Naltrexone

Naltrexone can produce some side effects which include:

• Nausea and vomiting
• Headache
• Dizziness
• Sleepiness
• Decreased appetite
• Pain in the Joints
• Muscle cramps
• Cold symptoms
• Insomnia
• Toothaches

More serious side effects can include reactions at the injection site, which can cause severe pain and tissue death; liver damage; allergic reactions; pneumonia; and depression.

Treatment for OUD and AUD

It’s important to understand that naltrexone should be part of an overall treatment plan. Naltrexone is simply a tool to reduce cravings and prevent relapse.

The first phase of both opioid and alcohol addiction treatment is a period of inpatient supervised detox. The goal is to keep you safe and comfortable, and to ease withdrawal symptoms, sometimes with medications.

Opioid withdrawal symptoms may include:

• Achiness
• Fever and chills
• Increased heart rate
• Diarrhea and vomiting
• Sweating
• Insomnia
• Anxiety

Alcohol withdrawal symptoms include:

• Shaking, particularly the hands
• Nausea or vomiting
• Headache
• Insomnia
• Sweating
• Anxiety

More serious withdrawal symptoms may also occur, including hallucinations, increased heart rate and blood pressure, and seizures. Because of the risks of these severe symptoms, a medically supervised alcohol detox is very important.

After detox is over, naltrexone treatment may begin.

But treating any addiction must also include therapy, both in an inpatient setting and after leaving inpatient treatment.

An inpatient program may be for 28 days, or sometimes longer for severe addictions. Detox will occur during this period, followed by intense therapy, both individual and group.

Cognitive behavioral therapy is a common therapy used in opioid and alcohol addiction treatment and has shown promising results. It involves learning to recognize your “addict thinking” and to changing your thinking to be based in reality.

For example, if you think “I can just drink on the weekends” or “I can cut back on heroin without quitting altogether,” you’ll learn to stop, think it through reasonably, and come to a realistic conclusion.

Cognitive behavioral therapy also teaches coping skills and problem solving so that you can face life’s challenges without using substances.

Cognitive behavioral therapy is one that we use at Bridges of Hope because it’s proven to be very effective.

Another type of therapy is motivational enhancement therapy, in which you learn to build motivation to stop your substance abuse. It involves goal setting both in terms of recovery and in life.

Positive reinforcement therapy may also be part of your treatment, which rewards you for good behavior, such as passing a drug test.

Group therapy is also critical in any addiction treatment program. Group therapy has an education component, in which you learn more about addiction, its causes, and how it affects you both physically and mentally. Group therapy is also an opportunity for patients to share their stories, emotions, and strategies for preventing relapse.

Patients also provide each other with support and companionship, and feel less isolated, knowing that they are not alone in facing their addiction challenges.

After inpatient treatment, ideally therapy should continue in a partial hospitalization program (PHP) followed by an intensive outpatient program (IOP). PHP involves attending therapy for four to six hours per day for four to six weeks. IOP generally requires two to three hours of therapy, three to five days a week, for six weeks or longer. Both programs involve individual and group therapy.

Individual therapy is also recommended on an ongoing basis to reinforce strategies learned and to work through challenges. Many also find it useful to attend addiction support groups or to join peer support programs, which give you an opportunity to interact individually with someone else who is in recovery.

In Closing

It’s important to remember that one, naltrexone can be an effective tool in addiction treatment and is not addictive. Two, naltrexone is not a stand-alone treatment, but part of an overall treatment program. It cannot replace the therapy and peer support that are necessary to truly treat your addiction.

If you’re struggling with an OUD or AUD, help is available. Your doctor can provide advice and resources, or you can reach out to a treatment center like Bridges of Hope to learn about treatment options. That first call is the first step on your journey to a more fulfilling and productive life.