• Naltrexone blocks the euphoric effects and feelings of intoxication (the “buzz”) from alcohol when you drink it.
• This allows people with alcohol use disorder to lessen their drinking behaviors enough to stay in treatment, avoid relapses, and take their medication. Over time, your cravings for alcohol will decrease.
• However, naltrexone will not prevent you from becoming impaired while drinking alcohol. Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol.

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.

Naltrexone comes as a long-acting intramuscular injection given once a month (brand name: Vivitrol), or as an oral tablet usually taken once daily (generic). It is approved for use in adults 18 years of age and older.

You should not be actively drinking at the time you start naltrexone treatment for alcohol use disorder.

• You should be able to abstain from alcohol in an outpatient setting (for example: at home, work and in your community) prior to starting treatment with naltrexone.
• However, naltrexone treatment must be used as part of a counseling program that includes support groups or other behavioral techniques as recommended by your doctor.

One study showed that a period of alcohol detoxification or a period of abstinence before naltrexone treatment is associated with greater effectiveness for naltrexone. If you aren’t drinking alcohol, naltrexone can help you remain sober.

Naltrexone use for either opioid use disorder or alcohol use disorder can lead to withdrawal symptoms if you are still using narcotics (opioids), including heroin. You need to be free from opioids for 7 to 14 days before naltrexone treatment, depending upon which opioid you are taking. You may need to undergo a medically-supervised opioid withdrawal.

Tell your doctor of any recent use of opioids or any history of opioid dependence before starting naltrexone. Opioid withdrawal with naltrexone can be serious and may require hospitalization.

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 judgement.
• 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.

How does naltrexone make you feel?

Most people feel no ill effects from naltrexone. It can lessen the enjoyment that people derive from drinking, as you don’t feel the “buzz” that is linked to enjoyment with drinking. However, by breaking this learned connection in your brain between drinking and pleasure, it can help you to stop drinking.

Naltrexone will not make you feel sick or ill in the same way that Antabuse (disulfiram) does when you drink alcohol with it.

Naltrexone is usually well tolerated, and has few side effects. Side effects you might notice include:

• nausea (10%)
• headache (7%)
• dizziness (4%)
• nervousness (4%)
• fatigue (4%), somnolence (2%)
• trouble sleeping (3%)
• vomiting (3%)
• anxiety (2%)

Naltrexone can cause depression in some patients. Tell your doctor if you have a history of depression, attempted suicide, or other mental health disorders before you start treatment. Tell your family members, friends or other people close to you that you are taking naltrexone. They should call a doctor right away if you become depressed or experience symptoms of depression.

Do not drive, operate heavy machinery or perform any dangerous activities until you know how naltrexone will affect you. Naltrexone may cause dizziness and drowsiness and affect your ability to drive or operate machinery. Do not drive or perform any kind of hazardous tasks if naltrexone causes you any dizziness or other dangerous side effects.

Do not exceed the dose prescribed by your doctor. Higher doses of naltrexone day may lead to liver injury.

Bottom Line

• Naltrexone blocks the pleasurable effects and feelings of intoxication (the “buzz”) from alcohol consumption.
• By breaking the link between pleasure and drinking, your cravings for alcohol over time may decrease. This can help you to stay sober.
• Naltrexone will not prevent you from becoming impaired while drinking alcohol. Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol.
• You need to have stopped opioid (narcotic) use for at least 7 to 14 days before starting treatment with naltrexone to help prevent withdrawal symptoms. Discuss this with your doctor.

This is not all the information you need to know about naltrexone for safe and effective use. Review the full naltrexone prescribing information and discuss this drug with your doctor or other health care provider.