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Naltrexone For Alcohol Use Disorder (AUD)

Published on May 18, 2021
Naltrexone Oral (Vivitrol & Revia) For Alcohol Use Disorder (AUD)

Naltrexone, sold under the brand names Vivitrol and Revia, is a medication commonly prescribed to support those who have stopped all alcohol consumption. It reduces cravings and blocks the effects of alcohol should relapse occur.

How Naltrexone Works

First approved by the FDA for medical use in the United States in 1984, naltrexone (not to be confused with the opioid overdose antidote naloxone) is an antagonist of opioid receptors in the human nervous system.

This means that the medication blocks receptors that generate physical effects, including pleasure and euphoria, when opioids like heroin, oxycontin, or fentanyl are taken.

Accordingly, naltrexone is frequently prescribed during recovery from opioid addiction.

Naltrexone & Alcohol

On the surface, this seems like it should have nothing to do with alcohol, which is not a narcotic. 

But the relaxation and positive feeling associated with alcohol result, at least in part, from the alcohol-induced release of the endogenous (human-made) opioid dynorphin. And this effect is what naltrexone, an opioid antagonist, is believed to interfere with.

Benefits Of Naltrexone Treatment For Alcohol Use Disorder (AUD)

When naltrexone is taken as part of medication-assisted treatment (MAT) in a recovery program, it is intended to have the following beneficial effects:

  • reduction in alcohol cravings
  • reduction in the rewarding/pleasurable effects of alcohol use if it does occur
  • is not habit-forming
  • comparatively fewer and less-severe side effects than alternate treatments 
  • aids other forms of treatment, including therapy and counseling

Naltrexone helps those with alcohol dependence deal with their urges, drink less if they do drink, and not feel the same pleasure or reward as a result of drinking.

However, naltrexone does not interfere with the other effects of alcohol intoxication, including impaired judgement and coordination following heavy drinking.

Naltrexone Use For AUD

Oral naltrexone tablets are likely taken once per day. A slow-release injectable form is also available for once per month administration.

Naltrexone should only be taken when prescribed by a health care provider and should not be used if you: 

  • are currently using opioids
  • have not completed a 7-10 day detox process
  • have hepatitis or liver problems (common among those who chronically abuse alcohol) 
  • are pregnant

How Long Can You Take Naltrexone For Alcohol Addiction?

While it can be used for short periods, evidence suggests that this medication works best when used for a period of at least three months. This length provides long-term management of alcohol cravings and supports those in recovery.

Because naltrexone’s side effects are so mild in the vast majority of cases, and because the drug is not habit forming and does not cause long-term health effects, there is no specific upper limit to the amount of time the medication can be safely taken.

Side Effects Of Naltrexone

Naltrexone’s effects are well documented and understood. Common side effects are usually mild, and may include:

  • abdominal pain
  • muscle and joint aches and pains
  • anxiety or nervousness
  • changes in energy/fatigue
  • chills
  • constipation/diarrhea
  • insomnia
  • nausea and vomiting
  • rashes
  • ringing in ears

Adverse Effects

In rare cases, or if used in high doses or otherwise misused, naltrexone can also cause serious liver damage, suicidal thoughts, hallucinations, blurred vision, swelling, and shortness of breath.

Seek medical care if you or someone near you who is taking naltrexone experiences unusual bruising or bleeding, extreme loss of appetite, yellowing skin or eyes, dark urine, or upper stomach pain.

Naltrexone & Holistic Care

Evidence shows that the use of naltrexone is effective in helping those with AUD control and reduce their cravings and likelihood of relapse. But naltrexone isn’t a magic bullet or a cure-all for alcohol abuse, and prescribing it alone will likely not successfully end alcohol addiction.

Remember, naltrexone cannot be taken during withdrawal when alcohol withdrawal symptoms and cravings are at their absolute worst. And even after withdrawal is over, naltrexone may only blunt cravings to a certain degree, instead of stopping them entirely.

Naltrexone, as with any medication prescribed to support those in recovery from a substance use disorder, must be used as one element of a holistic treatment approach. 

Therapy, Counseling, & Peer Support

Other elements may include cognitive-behavioral therapy (CBT), counseling, motivational interviewing, family therapy, peer support group participation, and even alternative therapies like nature therapy, exercise, yoga, and meditation.

A holistic approach is designed to give participants the tools they need to cope with the stresses and challenges of everyday life without falling back on substance abuse. Care is supported by medications that help reduce the physical and mental weight of cravings and dependence.

Addiction treatment centers provide a wide range of evidence-based care for substance use disorders. Available services include dual diagnosis treatment, medication-assisted treatment, behavioral therapy, and both inpatient and outpatient care.

Contact our team today to learn if our treatment programs are the right option for you.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

Food and Drug Administration (FDA) - REVIA® (naltrexone hydrochloride tablets USP)
National Institute on Alcohol Abuse and Alcoholism (NIAAA) - Alcohol's Effects on the Body
Substance Abuse and Mental Health Services Administration (SAMHSA) - Incorporating Alcohol Pharmacotherapies Into Medical Practice

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