Naltrexone

Naltrexone is a medication that is often used to treat opioid addiction or alcohol dependence. Used in conjunction with various forms of behavioral therapy, naltrexone has the power to reduce opioid cravings or to limit the urge to drink alcohol. This medication can be extremely useful in treating addictions to opioids or alcohol. At SJRP our medical team often recommends Naltrexone therapy alongside the behavioral and support therapies that are used to guide the recovery process.

For information about Naltrexone therapy for the treatment of alcohol addiction or to treat opioid dependence, call our admissions team at 833-397-3422.

With the ever-increasing use of opioids that has swept across the nation, there has been a heightened sense of urgency that has risen in the fight to stop opioids from destroying the health of so many individuals. The United States is responsible for 80% of the global opioid supply that is consumed, in 2015 an estimate of 300 million prescriptions were written for prescription pain pills.“Approximately every 12 minutes, someone overdoses on opioids”

One of the agents that have been used to combat opioids and promote the recovery process is Naltrexone.

Naltrexone hydrochloride a.k.a Naltrexone hcl is an anti-opioid agent that is used to aid in the withdrawal process from narcotics such as heroin, oxycodone, and morphine. The opioid agent was invented in the early 1960s to help treat individuals who were struggling with addiction from various narcotics. Fast forward almost 60 years later, low dose Naltrexone is being used frequently with successful results from individuals who previously struggled with addiction to narcotics.

What is Naltrexone?

With all of the various forms of medication-assisted treatment that are available for individuals in recovery. It can be confusing and overwhelming to research each drug and its effect.

A common question that comes up is:

“What is Naltrexone?”

Naltrexone is an opioid opponent that works to fully diminish the effects that narcotics such as have on the brain and the body. Naltrexone is essentially a “good drug” that is used in medicated assisted therapy (MAT).

Another is:

“What is Naltrexone used for?”

It suppresses the user’s desire to continue the use of opioids and the reward center of the brain that induces pleasure and euphoria. Naltrexone can appear in different forms one of the most popular forms of administration is the naltrexone implant.

FDA Approval of Naltrexone

Even though Naltrexone was created in the early 1960s by Endo Laboratories, there were no Naltrexone FDA approved uses until 1984 when it was approved for alcohol therapy. The anti-opioid agent was not approved by the Food and Drug Administration until the beginning of 1994 for opioid dependence uses. Ever since the FDA approved Naltrexone, it has been a staple for doctors who facilitate medication-assisted treatment for individuals in recovery. Naltrexone FDA approval has been incredibly beneficial for thousands who are seeking treatment for substance abuse.

Naltrexone for Opioid Addiction

Being one of the most advanced treatments used for substance abuse, naltrexone for opioid abuse has shown great success for individuals who have used it as part of a treatment regimen. The primary use of Naltrexone is to aid individuals who are suffering from extreme cases of opioid abuse. Naltrexone blocks opioid receptors by suppressing the desire and insatiable craving for opioids such as heroin, oxycodone, or fentanyl. Naltrexone works by binding to the opioid receptors in the brain so that the use of opioids have little impact on the user.

When Naltrexone is used, the opioid user does not feel the euphoria or other physiological changes that take place with opioid use. Cravings are reduced and there is less of a desire to use. Naltrexone works to help the user feel like he or she doesn’t need (or benefit from) opioids.

Naltrexone for Alcohol Addiction

Naltrexone for alcohol abuse has been proved to be highly effective for those in recovery. Naltrexone and alcohol are one of the most popular methods to combat excessive alcohol use. The patient can slowly reduce their alcohol intake by ingesting a dose of Naltrexone before taking a drink. The body quickly acclimates to the reduction of drinking, until there is no longer a desire to drink with little to no withdrawal experience. Naltrexone alcohol has been proven time and time again to be a highly effective method.

Dosage and Administration

There are three basic forms of administration for Naltrexone:

  • Oral consumption can be administered by the patient once daily, the average Naltrexone dosage is 50 milligrams per tablet
  • The second form of administration is done at a hospital or clinic and injected intravenously, this is conducted once a month with an average of 380 milligrams per dosage.
  • An implant can be placed under the skin with a slow-release time over a period of 8 weeks for a patient to experience continued effects.

Naltrexone Effectiveness

Opiate antagonist naltrexone has been proven to be one of the most effective methods for individuals who are struggling with the use and abuse of opioids and excessive alcohol consumption. Naltrexone is not known for its addictive properties and the implementation of the Sinclair method (taking a dose of Naltrexone before consuming alcohol) has proven success rates of 90% in patients who frequently consumed alcohol and 80% for those consuming opioids. Naltrexone reviews for opiate addiction have the best results that have been proven when used in combination with therapy treatments and activities that help to boost endorphins and release of dopamine in a healthy way.

Naloxone vs Naltrexone

While similar in namesake and side effects there are distinct differences between the two anti-opioid agents. In the analysis of Naloxone vs Naltrexone; Naltrexone’s instinctive purpose is used as a preventative measure and medicated assisted treatment program for opioid and alcohol abuse. Whereas Naloxone is administered via the nasal cavity to rescue individuals from overdosing and protect the respiratory system from damage due to the overuse of opioids such as heroin.

Naltrexone vs Suboxone

As mentioned above, the primary use of naltrexone is a preventative measure for persons at risk of relapsing into opioid or alcohol use. Similarily, Suboxone was created as a short term “cure” for opioid users. Suboxone treatment has a high rate of success as shown by the National Institute on Drug Abuse, out of 600 people addicted to painkillers, those who took Suboxone had a 49 percent reduced usage of prescription pills.

The affordable cost and low rate of abuse in comparison to other opioid antagonists makes Suboxone a game-changer in treating opiate addiction. Suboxone can appear in three forms: tablet, pill capsule, or sublingual film, However, Suboxone is not intended for long term use because this opioid antagonist produces more side effects than any other anti-opioid medication. In a standby comparison of Naltrexone vs Suboxone, Suboxone side effects are almost double that of Naltrexone. For long-term medication-assisted treatment for opioid dependence, Naltrexone is a safe alternative to Suboxone.

Naltrexone vs Narcan

Similar to other anti-opioid agents, Narcan is the generic version of Naloxone and is used to block the effects of opioid overdose. Naloxone blocks overdose symptoms that can occur when an individual has taken took much of an opioid. Naloxone is administered to reverse the effects of labored breathing or a loss of oxygen that occurs in early opioid overdose. In comparing Naltrexone vs Narcan, as mentioned Naltrexone is used primarily in the medicated assisted treatment of opioid use disorders-not for quick-acting use. Likewise, Narcan is a quick-acting medication used to reverse the effects of opioids.

Naltrexone vs Methadone

Methadone is similar to Naltrexone in its ability to reduce cravings for opioids and manipulate the brain receptors that interact with the reward center of the brain. However, in comparison to Naltrexone vs Methadone, Methadone has one of the highest rates of retention of any opioid at 80% and can be administered in three different forms via capsule pill, tablet, or intravenous injection. Unfortunately,  use of methadone may be addictive for some making it difficult to discontinue use.

Naltrexone Drug Interactions

Like any other drug, any foreign substance that enters the body can interfere with individual chemistry and may have the potential to create unwanted or unintended side effects or unique naltrexone drug interactions. Certain substances may cause more damage than others when they are used in conjunction with Naltrexone. Even low dose naltrexone drug interactions may occur — interactions are not limited to those on high dose drugs.

Before you take Naltrexone, be sure you’ve talked with a medical professional about the various substances you are using. To learn more about Naltrexone therapy & the risk associated with this medication as it may be prescribed in an addiction treatment setting, call the SJRP admissions team at 833-397-3422 to speak with an admissions specialist.

  • Opiates:  Taking naltrexone with opiates in your system can produce what’s known as precipitated withdrawal. This is essentially an accelerated, early withdrawal process. It can be extremely painful and scary if you’re not prepared. In fact, taking naltrexone while on opiates can be very intense and incredibly dangerous if you are not under the scrutinous watch of a medical professional.  WARNING: Mixing opiates with Naltrexone can result in precipitated withdrawal which may be painful & dangerous.
  • Disulfiram: Naltrexone and disulfiram can be used to reduce alcoholism by limiting alcohol use patterns. Generally, Naltrexone and acamprosate (Campral) would be recommended as FDA-approved treatment options for alcohol dependence when paired with conjunctive therapies. Antabuse (Disulfiram) and Naltrexone may be useful in treating dually diagnosed cocaine and alcohol dependence according to recent clinical trials. WARNING: Mixing Disulfiram & Naltrexone may cause liver problems.
  •  Suboxone: The use of Naltrexone with Suboxone (buprenorphine/naloxone) is not recommended. Naltrexone blocks the effects produced by the buprenorphine making the medication less effective in treating opiate addiction. Naltrexone may also precipitate withdrawal symptoms if you have taken buprenorphine for a while. It is very important to be honest with your treatment provider to ensure precipitated withdrawal does not occur.
  • OTC/Prescribed Cough Medications: These medications are often ingested to help ease a relentless cough and reduce the pain that comes along with it. However, when OTC medications are taken simultaneously with naltrexone there will be little pain relief aspect that will not be of use.
  • OTC/Prescribed Diarrhea Medications: When using Naltrexone, certain over the counter or prescribed diarrhea medications may not be as effective. Loperamide, a commonly used OTC diarrhea medication found in Immodium), may cause precipitated withdrawal symptoms if Naltrexone is used within a short timeframe of the previous use of Immodium to stop diarrhea.

Naltrexone Side Effects

While Naltrexone has incredibly positive effects for individuals who are in the recovery process, certain side effects might appear with the use of this powerful medication. Naltrexone side effects may include:

  • Nausea
  • Vomiting
  • Low dose naltrexone side effects are known to cause headaches and pain
  • Dizziness
  • Fatigue
  • Nervousness
  • Anxiety
  • Diarrhea, constipation and abdominal pains
  • Chest pain, joint/muscle pain
  • Rash
  • Sleeping problems
  • Insatiable thirst
  • Changes in appetite
  • Increased sweating
  • Increase in tearing
  • Mild to severe depression

Naltrexone Warnings

Naltrexone warnings should not be taken lightly. The original form of Naltrexone features a black box warning that is not meant to scare users, but to create awareness as to the intensity of the drug. while essentially the opioid antagonist is known for its benefits in recovery-it has many side effects that should be reviewed carefully before consumption.

  • Naltrexone should not be used with individuals who have hepatitis or issues with liver processing.
  • Naltrexone should not be used by those with a history of kidney problems.
  • Naltrexone should not be used by those with a history of liver problems.
  • Naltrexone should not be used by those with a history of chronic pain or illnesses.
  • Naltrexone should not be used by those with a known history of blood clots.
  • Naltrexone should not be used by those with a history of prior complications with naltrexone use.
  • Naltrexone should not be used by those who are pregnant, or by nursing women.
  • Naltrexone should not be used by those up are younger than 18 years of age. Naltrexone is not approved by the FDA for minor-administration.
  • Naltrexone should not be used by individuals who have had negative effects with the co-use of pain medication and naltrexone previously
  • Naltrexone should not be used by those individuals currently using opioids or have used in within 72 before administration of Naltrexone

The FDA has mandated a black box Naltrexone warning card on all packaging due to the very rare side effect of liver and kidney complications with extended use of the anti-opioid agent.

Precipitated Withdrawal

Precipitated withdrawal is essentially a withdrawal process that is intentionally “sped up” when there is no time left between the last use of an opioid and the first dose of Naltrexone. The basic time frame before naloxone can safely be administered following opiate use is a minimum of 3 days and ideally 10 days following the last dose of opioid-containing drugs.

Unlike other withdrawal processes that can occur over the course of several days, up to a week,  precipitated Naltrexone withdrawal can be triggered within minutes following the administration of naltrexone and the results may be extremely intense for the person in recovery. Side effects from precipitated withdrawal may include:

  • Seizures
  • Abdominal cramps
  • Increased heart rate
  • Reduced blood pressure
  • Nausea and Vomiting
  • Diarrhea
  • Pain and discomfort

It is important to only consume any opioid, especially naltrexone and alcohol withdrawal treatment under the guidance and instruction of your licensed medical provider.

Naltrexone During Pregnancy

It is generally not advised to use low dose naltrexone during pregnancy or when nursing. Discuss the use of Naltrexone during pregnancy with your healthcare provider. If taking Naltrexone during pregnancy, keep in mind that there must be a significant time frame of at least 7 days to ensure there is no presence of opioids remaining in the body and that there is no risk that remnant opioids can trigger a precipitated withdrawal. Remember, opioids may be harsh on the body of the expecting mother and the child she is carrying if there is a miscalculation and precipitated withdrawal occurs. The use of Naltrexone while pregnant should be carefully discussed with a licensed medical provider.

Naltrexone Overdose Risk

Can you overdose while on naltrexone? In short, the answer is:

Yes.

In studies that have been conducted in relation to a Naltrexone overdose, generally, the individual who has overdosed has experienced a significant loss of tolerance to the opioid that has been consumed and this has led to an unfortunate overdose. Other reasons for overdose could include discontinuation of treatment with a return to opioid or alcohol abuse. Or polysubstance abuse resulting in the toxic level presence of more than one narcotic substance in the body, often leading to a fatal overdose.

It’s important to note that the actual overdose of Naltrexone is rare. While naltrexone does have the potential to be abused, Naltrexone prescriptions on the street are generally paired with Bupreorphine which has a substantially lower rate of abuse than the former. Therefore the risk of naltrexone overdos