Can Naltrexone be Abused?

An estimated 10% of all U.S. adults are addicted to drugs and alcohol. Problem drinking is associated with an increased risk of violence, accidents, and suicide. When it comes to drug abuse and addiction, opioid drugs like heroin and prescription narcotics are the number one culprit behind the increase in overdose death rates since the early 2000s. Although addiction is a severe and chronic disease, it can be effectively managed. With comprehensive treatment plans, people can go on to make a full recovery from drug or alcohol abuse.

For treatment to be a success, patients in recovery require integrated, holistic treatment plans. In some cases, those treatment plans will include prescriptions for medicines that are designed specifically to treat people in recovery for opioid or alcohol addiction. One medication that’s been manufactured and distributed for this purpose is Naltrexone.

What is Naltrexone?

Naltrexone is a prescription medication specifically approved by the FDA for treating both opioid dependence and alcohol use disorder. Naltrexone can be taken as either a tablet or an injectable, and most patients are given a dose of 50 milligrams once per day. The injectable form of the drug is called Vivitrol. Vivitrol is given intramuscularly at 380 milligrams once per month. Only licensed healthcare practitioners can administer Naltrexone in any of its forms.

Taking Naltrexone before fully detoxing from opioids or alcohol can cause severe withdrawal side effects. For patients who wish to use Naltrexone, they will need to abstain from drugs for at least seven to ten days before starting the drug. This includes patients who have used Methadone and are switching to Naltrexone.


Can people abuse Naltrexone?

Unlike other medications used to treat opioid addiction, specifically, Naltrexone will not get someone high, and people do not typically abuse this drug to induce euphoria. However, medicines like Suboxone and Methadone can come with a risk of abuse and addiction. Sometimes, patients in recovery for opioid dependence who have abused these two medicines will be switched to Naltrexone. Naltrexone is non-addictive.

How does Naltrexone work?

Opioid drugs produce an intense, highly addictive euphoria that completely rewires the brain’s risk and reward neural pathways. For people addicted to opioids, it can be incredibly challenging to go through the withdrawal process and manage cravings without help from medications combined with customized therapy sessions. Also, people who have achieved initial sobriety from opioids, but relapse, are at high risk of experiencing a fatal overdose. The body quickly loses its tolerance levels to opioid drugs once someone enters a recovery period. Users who are relapsing can take more of an opioid than their body can handle, thinking they still have a tolerance to the drugs. But taking Naltrexone can reduce this risk.

Naltrexone works by blocking the euphoric, soothing effects of opioid drugs. Naltrexone differs from Methadone and Buprenorphine. These medicines activate opioid receptors in the body and help reduce cravings for drugs. Instead, Naltrexone binds and blocks opioid receptors, reducing cravings, and preventing opioid drugs from taking effect if someone relapses. With Naltrexone, there is no risk of abuse or diversion, because the medication doesn’t activate the opioid receptors in the brain at all. People on Naltrexone should not only maintain abstinence from opioids, but they should also avoid sedatives, tranquilizers, and other illicit drugs.

How is Naltrexone used to treat opioid and alcohol dependence?

People in recovery for opioid addiction can use extended-release, injectable Naltrexone to maintain sobriety. However, before starting Naltrexone, patients must be fully detoxed from all opioid drugs. Naltrexone is highly effective at decreasing both a person’s reaction to opioid medications and their cravings for opioids. However, taking Naltrexone will also lower someone’s tolerance to opioids. Patients who relapse may not realize how much more sensitive they are to opioid drugs. It is critical that patients in recovery to opioids continue to receive comprehensive care from a team of experienced clinicians to prevent relapse.

As part of a treatment plan for alcohol addiction, Naltrexone also works to block the pleasurable effects of alcohol and feelings of intoxication. Naltrexone won’t interact poorly with alcohol if someone relapses. Researchers agree that for Naltrexone to be most effective, patients should be on Naltrexone therapy that is longer than three months. Naltrexone is safe to use indefinitely for treating both alcohol and opioid addiction disorders.

Are there side effects to using Naltrexone?

All medications come with a risk of side effects, some more severe than others. Naltrexone does come with a range of side effects, but it is not safe for users to suddenly quit taking Naltrexone without first consulting with their doctor. If side effects of Naltrexone become too much, doctors can reduce the dose or replace Naltrexone with a different medicine to treat opioid addiction or alcohol addiction. Most Naltrexone side effects will diminish over time. The most common side effects include:

  • Stomach upset and nausea
  • Headaches
  • Nervousness
  • Sleep issues
  • Aches and pains

In rare cases, Naltrexone can produce severe side effects, including liver damage, or reactions at the injection site if a patient is taking injectable Naltrexone. For a minority of Naltrexone users, the medication can cause allergic pneumonia. Any time a person experiences these side effects, they should consult their physician asap.

Can people overdose on Naltrexone?

In theory,  it is possible to overdose on Naltrexone, but it is unlikely. What could happen is someone could take a large dose of opioid drugs or drink a lot of alcohol to try to overcome the effects of Naltrexone, which could lead to an overdose. But this is highly unlikely because, for someone to obtain a prescription for Naltrexone in the first place, they must be detoxed from either opioids or alcohol first.

Is Naltrexone the same as Narcan?

It’s essential for people to understand that Naltrexone is not the same as Narcan, also called Naloxone. While these two drugs may look and sound the same, they are fundamentally different. Naltrexone does not reverse the effects of opioids; it blocks the euphoric feeling they produce. Narcan, on the other hand, changes the side effects of powerful opioid drugs like heroin and effectively reverses the course of an overdose. When someone is overdosing from opioids, it is critical that they get swift medical treatment. Many emergency responders carry doses of Narcan with them if they need to reverse a fatal overdose that may arise.

What are the signs of an opioid overdose?

Signs of an opioid overdose include blue-tinged lips and fingernails, confusion, slurred speech, and unresponsiveness. Pinprick pupils and clammy skin are also signs of an impending overdose. If someone is suspected of overdosing, it is critical that bystanders do not leave them unattended. Call 911, and make sure an unresponsive person is lying on their side, and not their back. An opioid overdose can lead to nausea and vomiting while someone is unconscious, which can cause them to aspirate.

How does Naltrexone fit in with an integrated treatment plan for addiction?

Addiction is a disorder that is lifelong and chronic. New research into addiction suggests that the disease is similar to other chronic health conditions like hypertension or diabetes. Like these health issues, addiction also requires maintenance and ongoing care from a team of clinicians. Relapses can and do occur with physical health issues, and the same is true for addiction. While it is ideal to try and prevent a relapse from ever happening, integrated treatment models take into account the risk of relapse and how to prevent it from happening, and what to do if someone does retake drugs or starts drinking again.

Integrated, comprehensive treatment models for addiction take into account the whole person’s medical history and their triggers and reasons for using drugs or alcohol. Medications like Naltrexone are just one part of the multi-faceted approach that integrated, comprehensive treatment models possess. For patients in recovery, it is ideal for them to get treatment from a behavioral therapist to explore their triggers, and motivations for drug use and how to address these issues. Medications can help someone maintain their sobriety by reducing cravings or blocking the effects of drugs if patients relapse.

Furthermore, addiction treatment plans need to include ongoing, contingency plans for maintaining sobriety. This may include the use of sober living facilities, pre-scheduled one-on-one therapy sessions, or attending support groups after inpatient or outpatient rehab is completed. For some patients, they may need to use Naltrexone for an extended period to get the most benefits out of the medication and maintain their sobriety. Also, taking Naltrexone requires patients to complete detox before starting the drug. Attending an inpatient or intensive outpatient treatment program for detox purposes is ideal and the safest option for patients during this critical phase of the recovery journey.

If you or a loved one are struggling with drug or alcohol addiction, it is never too late to get help. The representatives at Mission Harbor Behavioral Health are standing by to answer your questions about treatment and recovery. Please contact Mission Harbor today to learn more about our comprehensive, integrated recovery plans for addiction.

The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.

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