Naltrexone

In 2023, the annual National Survey on Drug Use and Health showed that an estimated 28.9 million people over the age of 12 had an alcohol use disorder (AUD). According to one 2016 study, alcohol is one of the most commonly abused substances in the world. Alongside alcohol, opioids, both illicit and prescription, are also commonly misused, with one 2022 study noting that as many as 7.6 million adults in the United States have opioid use disorder (OUD).

No matter the substance, navigating substance use disorder can be challenging. Addiction can impact every part of an individual’s life, from their relationships to their work or schooling, and seeking recovery can be daunting. However, help and treatment are available, including medication-assisted treatment (MAT). According to one study published in 2022, medication-assisted treatment can offer a variety of benefits, including reducing substance abuse and improving health.

What is Medication-Assisted Treatment?

Medication-assisted treatment is a whole-patient approach to substance use disorder (SUD).

When an individual uses a substance, including alcohol or opioid, it can cause changes to the body, especially brain chemistry. For example, opioids can send specific signals to the brain, reducing pain and causing euphoric effects. Over time, and especially with misuse or abuse, the body can become accustomed to these changes. As a result, these effects begin to feel natural to the brain or body.

During treatment for a substance use disorder, the individual no longer uses the substance. In the example above, as the remaining traces of opioid are expelled from the body, brain chemistry reverts back to natural levels. This can be uncomfortable, and it can cause a variety of symptoms known as withdrawal syndrome.

Withdrawal can make recovery challenging. Not only can it introduce psychological cravings for a substance, but it can have physical effects like nausea and body aches. This is where medication can be beneficial, as it works to address the symptoms of withdrawal and make focusing on recovery more accessible.

However, medication alone is not an effective approach to addiction. Instead, medication-assisted treatment pairs the use of professionally managed medication with different types of healthcare services, namely therapy and counseling. This helps treat not only the symptoms of addiction but the root causes as well.

Nobody experiences substance use disorders and addiction the same way. Because of this,  while medication-assisted treatment can be a beneficial and effective treatment for those navigating SUDs, it may not be the best treatment for everyone.

What Is Naltrexone?

Naltrexone is an FDA-approved medication used for the treatment of specific substance use disorders. It is a generic medication that is available through several different brand names, including those such as ReVia, Vivitrol, and Depade. Some of these brand names  have been discontinued and are no longer available except for in the generic form.

What Is Naltrexone Used To Treat?

Naltrexone is used to treat two specific types of substance use disorders: opioid use disorder and alcohol use disorder.

Also known as opioid dependence or addiction, opioid use disorder is a type of SUD revolving around the misuse and abuse of opioids. This can be prescription opioids or illicit forms. Opioid use disorder, like other types of substance use disorders, is a chronic condition.

Alcohol use disorder, or alcoholism, includes many of the key features of other SUDs. This includes an inability to regulate drinking, which can lead to abuse. Studies such as this 2023 publication highlight the fact that alcoholism may have genetic and hereditary components.

In both of the conditions, naltrexone helps prevent the substances from interacting with the body. When someone uses opioids or alcohol, it binds with specific regions in the body and sends signals to the brain that can release euphoric effects, which can lead to dependency.

How Is Naltrexone Administered?

Naltrexone can be administered in two different ways: as an oral tablet or as an injection. When taken as a tablet, Naltrexone is taken daily; as an injection, it is administered once a month.

What Are The Side Effects Of Naltrexone?

Naltrexone provides individuals with a variety of positive benefits. However, not everyone will have the same experience with medication-assisted treatment with naltrexone. Despite the potential benefits available with naltrexone, some individuals may experience side effects.

Some of the side effects that may occur with naltrexone include:

• Headache
• Difficulty falling asleep
• Body aches
• Dizziness
• Anxiety
• Gastrointestinal issues
• Irritability

The severity of side effects can vary, and not everyone who takes naltrexone will experience side effects. In rarer cases, individuals may experience more severe side effects, such as swelling. If you experience side effects while taking naltrexone, it’s important to reach out to your healthcare provider.

Naltrexone can also decrease an individual’s tolerance to substances. This can increase the risk of overdose in those who resume substance abuse during or after MAT with naltrexone.

MAT and Naltrexone Frequently Asked Questions

Medication-assisted treatment with naltrexone can be a beneficial option for those struggling with substance use disorders. Therapy and counseling can teach individuals essential skills for navigating their emotions while uncovering the genetic, environmental, and historical roots of addiction. Medications like naltrexone can target the discomfort that comes with withdrawal symptoms and recovery.

If you or a loved one are considering MAT with naltrexone, then you may have additional questions. This is especially true when it comes about accessing care, such as treatment duration or insurance coverage. Below, explore the answers to some of the most frequently asked questions about medication-assisted treatment and naltrexone.

It’s important to remember that naltrexone or any medication can impact individuals in different ways. For specific information about MAT and naltrexone, it’s best to reach out to your healthcare provider for the most accurate answers about your treatment options. This includes whether naltrexone is the right medication for your individual needs, preferences, and situation.

Is There A Danger Of Addiction With Naltrexone?

According to the University of Arkansas for Medical Sciences’ Psychiatric Research Institute, naltrexone is not considered to be addictive.

Just like different drugs, different medications used in MAT can have different effects on the body. Along with naltrexone, buprenorphine is one of the most common medications used in the treatment of opioid use disorder.

Buprenorphine is a type of medication known as a partial opioid agonist. What this means is that buprenorphine binds to the same areas as opioids, known as opioid receptors. This works in medication-assisted treatment as it prevents opioids from activating the receptors and producing euphoric effects.

However, buprenorphine, as a partial opioid agonist, does activate these receptors to some extent. As a result, it interacts with the body in a way similar to that of opioids, although the effects are milder. This causes it to have a potential risk of misuse.

Naltrexone, however, works differently in the body. While it binds to the same receptors as opioids and alcohol, similarly to buprenorphine and other medications used for OUD, naltrexone does not activate these receptors. Because of this, it can help block or reduce the effects of substances without producing any euphoric effects that may cause addiction.

How Long Does Treatment With Naltrexone Last?

Medication-assisted treatment with naltrexone or any other professional prescribed medication is not a one-size-fits-all treatment approach. Just as no two people experience addiction the same way, no two people undergo treatment the same way. As a result, there is no single timeline for how long treatment with naltrexone lasts.

Patients are often prescribed naltrexone for several months up to a year. In some instances, patients may not respond as well to naltrexone. If this occurs, their healthcare provider may end medication-assisted treatment with naltrexone early in favor of a different medication or treatment approach.

There are also different internal and external factors that can dictate how long treatment with naltrexone lasts. These can include:

• The type of substance being used
• The severity of the substance use disorder
• How long the individual has had a substance use disorder
• Any other co-occurring mental or physical health conditions
• The individual's medical history
• What other treatment methods are being utilized
• The individual’s response to MAT with naltrexone
• The individual’s available support network

To learn more about how long medication-assisted treatment with naltrexone may last for you, reach out to your healthcare provider.

Does Insurance Cover Naltrexone Treatment?

Whether or not your healthcare insurance will cover medication-assisted treatment with naltrexone depends on your specific plan and its coverage. Some public and private healthcare plans may not offer coverage for this form of treatment, and those that do may only offer partial coverage.

The best way to learn if any type of treatment is covered under your insurance, and whether that coverage is complete or partial, is to reach out to your insurance company. By speaking to a representative, you can learn what options are available to you. Your insurance representative may also be able to provide additional information of other expenses related to treatment, such as copays or any out-of-pocket expenses that aren’t covered.

If your insurance doesn't cover MAT with naltrexone, or if you don’t have insurance, reach out to your healthcare provider. Your doctor may be able to guide you along the next steps in treatment, including offering alternatives to medication-assisted treatment if needed. Depending on your region, there may also be assistance programs to help you access treatment.