Naltrexone is a medication that can help with both alcohol and opioid dependence.

For alcohol, Naltrexone can help decrease both the cravings for alcohol and the reinforcing euphoria one gets while drinking alcohol. It works by blocking several opioid receptors in the brain altering one’s response to alcohol consumption.

For opioids, Naltrexone blocks the euphoria from using opioids and provides an extra layer of support. It works by blocking the Mu opioid receptor, the same receptor that opioids bind to.

There are 2 forms of naltrexone:

  • Oral tablet
  • Long-acting injection (Vivitrol)

Both forms are effective, but the long-acting injection has greater adherence. Dosing is 50mg per day for the tablet and 380mg every 28 days for the long-acting injection.

To start Naltrexone, the tablet is given for about 1 week to ensure one can tolerate the medication without side effects. After 1 week, the long-acting form can be injected.

Most people tolerate Naltrexone without any side effects. Some common side effects include:

  • Nausea
  • Headache
  • Increased work of liver (5%)

Rare side effects:

  • Fatigue
  • Depression
  • Irritability
  • Constipation
  • High heart rate