Naltrexone Explained
What is Naltrexone
Naltrexone is a medication of the substituted oxymorphone class used in the treatment of alcohol and opioid dependence. Also known by tradenames including Adepend, Antaxone, Celupan, Depade, Nalorex, Narcoral, Nemexin, Revia/ReVia, Trexan, and Vivitrol, naltrexone has the chemical synonyms EN-1639A; UM-792; N-Cyclopropyl-methylnoroxymorphone; N-Cyclopropylmethyl-14-hydroxydihydro-morphinone; and 17-(Cyclopropylmethyl)-4,5a-epoxy-3,14-dihydroxymorphinan-6-one. It is typically taken orally, by subcutaneous implant or by intramuscular injection, and in the UK it is a prescription-only medicine.
What is Naltrexone Used to Treat?
Naltrexone has been most commonly used as a treatment for alcoholism, and has been demonstrated to decrease both quantity and frequency of drinking. It is also used to treat opioid dependency, decreasing both cravings and the risk of overdose.
Less commonly, naltrexone is also used to treat certain behavioural disorders including kleptomania and compulsive gambling; in the treatment of obesity; and as part of broader treatment programmes addressing dissociative symptoms such as depersonalisation.
Why use Naltrexone for Drug Addiction?
Naltrexone can be used as a substitute for heroin and other illicit opioids, decreasing personal risk and criminal liability due to its legal status, and enabling a more effective management of tapering (reducing dosages over time) as part of a gradual weaning process. In the treatment of alcoholism it has been seen to reduce cravings for alcohol in long-term addicts, decreasing the quantity of alcohol consumed and increasing the number of alcohol-free days in some addicts.
How Do Medications for Addiction Treatment Work?
Naltrexone works by blocking opioid receptors in the brain, reversibly preventing or attenuating the effects of opioids. Although how it affects alcohol dependence is not yet fully understood, it is thought to have a particular impact upon the dopaminergic mesolimbic pathway, which is one of the key reward and pleasure centres in the brain associated with addiction.
Is Naltrexone Effective at Treating Addiction
Naltrexone is seen as having a “modest” impact on alcohol addiction, with positive results in terms of decreasing quantity and frequency of alcohol consumption in some but not all recipients. In the treatment of opioid use disorder, it is seen as a useful and beneficial alternative to other substitutes such as methadone, and can have very positive results when used as part of a broader addiction treatment programme.
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Principles of Effective Naltrexone Addiction Treatment
Naltrexone should not be seen as a cure by itself for either alcoholism or opioid addiction; while it can have positive benefits in both cases, it should be taken as part of a broader addiction treatment programme (such as is provided in residential rehabilitation) combined with therapy and other treatment elements.
Naltrexone treatment for opioid addiction should not commence until a period (usually between seven and 10 days) of absence has been achieved, as taking naltrexone immediately after cessation of use can trigger acute opioid withdrawal.
Because of its potential side effects, naltrexone should only ever be consumed in accordance with the instructions of the prescribing doctor.
What are the Side Effects of Naltrexone
The most common side effects of naltrexone are gastrointestinal-related, including cramping, diarrhoea and nausea (which typically occur during opioid withdrawal). It has been reported to cause liver damage at high dosages, although these reports are still being studied and no firm correlation has yet been established between such effects and naltrexone consumption.
Naltrexone Is Most Effective When Combined with Addiction Therapy
As with all medication used in the treatment of addiction, naltrexone is most effective – and indeed should only ever be consumed – in conjunction with a broader addiction treatment programme including therapy. Therapy – in various forms and models – lies at the core of all addiction treatment, as it both uncovers and addresses the fundamental causes of the addiction, allowing the addict to focus on the factors which have resulted in their substance abuse and work on improving behavioural patterns; moreover, therapy can provide an addict with psychological defence mechanisms against relapse which can be deployed long after the initial treatment program itself has been completed.
Taking medication such as naltrexone can address and relieve physical dependence but does not tackle the underlying causes of addiction, paving the way for relapse and resumption of addictive behaviour potentially long after physical dependence has been overcome.
Get Help Today
If you are suffering from an addiction, the sooner you are able to acknowledge your condition, the sooner you can start to receive the help you need. If you are prepared to ask for help, there are a great number of facilities and organisations across the UK treating addicts daily which can give you the assistance you need. Speak with your GP and/or an addiction specialist today, and discuss treatment options which may be available to you which can get you back on the path to a happy healthy life.
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