Frequently Asked Questions for Naltrexone Patients
Table of Contents
- Beginning Naltrexone Treatment
- Living with Naltrexone Treatment
- Dealing with Potential Side Effects
- Long-term Naltrexone Use and Treatment Outcomes
- Practical Aspects of Naltrexone Treatment
- Conclusion
- Glossary
- References
- Related
Beginning Naltrexone Treatment
What is Naltrexone and how does it work?
Naltrexone is a medication used in the treatment of alcohol and opioid dependence. It works by blocking the effects of opioids in the brain and reducing cravings for alcohol. Naltrexone is an opioid antagonist, which means it binds to opioid receptors in the brain without activating them, effectively blocking the euphoric and sedative effects of opioids like heroin or prescription painkillers.
For alcohol dependence, Naltrexone helps reduce the urge to drink and can decrease the amount of alcohol consumed if a person does drink. It's important to note that Naltrexone is not a cure for addiction but rather a tool to be used as part of a comprehensive treatment program that includes counseling and support.
How long do I need to be opioid-free before starting Naltrexone?
You need to be completely opioid-free for at least 7-10 days before starting Naltrexone treatment. This period may be longer for long-acting opioids like methadone. The exact duration should be determined by your healthcare provider based on your individual circumstances.
It's crucial to be opioid-free because Naltrexone can cause severe withdrawal symptoms if taken while opioids are still in your system. Your doctor may perform a Naloxone challenge test to ensure you're opioid-free before starting Naltrexone.
Can I start Naltrexone while I'm still drinking alcohol?
Yes, you can start Naltrexone while still consuming alcohol. Unlike some other medications used to treat alcohol dependence, Naltrexone does not cause a severe reaction when combined with alcohol. However, it's important to be honest with your healthcare provider about your alcohol consumption and to follow their advice regarding drinking during treatment.
The goal of Naltrexone treatment for alcohol dependence is to reduce alcohol cravings and consumption over time, not necessarily to achieve immediate abstinence.
How quickly will Naltrexone start working?
Naltrexone begins working almost immediately after you take it. However, the full effects on cravings and behavior may take some time to develop. Some patients report feeling a reduction in cravings within the first few days of treatment, while for others, it may take a few weeks to notice significant changes.
It's important to continue taking Naltrexone as prescribed, even if you don't notice immediate effects. The medication works best when used consistently over time as part of a comprehensive treatment plan.
Will Naltrexone make me feel different or high?
No, Naltrexone does not cause a high or euphoria. It's not a narcotic or a sedative, and it doesn't cause physical dependence. Most people don't feel any different when they take Naltrexone, aside from potentially experiencing a reduction in cravings for alcohol or opioids.
Some patients may experience side effects, particularly when first starting the medication, but these are typically mild and tend to subside over time.
Do I need a prescription for Naltrexone?
Yes, Naltrexone is a prescription medication and can only be obtained with a prescription from a licensed healthcare provider. It's important to use Naltrexone under medical supervision as part of a comprehensive treatment plan.
How is Naltrexone different from other addiction treatments like methadone or buprenorphine?
Naltrexone works differently from medications like methadone or buprenorphine, which are opioid agonists or partial agonists. These medications activate opioid receptors to some degree, while Naltrexone blocks them completely.
Key differences include:
- Naltrexone is non-addictive and does not cause physical dependence
- There's no potential for misuse or diversion with Naltrexone
- Naltrexone requires complete detoxification from opioids before starting, while methadone and buprenorphine can be started while still using opioids
- Naltrexone can be used for both alcohol and opioid dependence
The choice between these medications depends on individual patient factors and should be made in consultation with a healthcare provider.
Living with Naltrexone Treatment
How do I take Naltrexone?
Oral Naltrexone is typically taken once daily as a pill. The usual dose is 50mg per day, but your doctor may adjust this based on your individual needs. It can be taken with or without food.
It's important to take Naltrexone regularly as prescribed. Many people find it helpful to take it at the same time each day to establish a routine. If you miss a dose, take it as soon as you remember, unless it's almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Never take a double dose to make up for a missed one.
Can I drink alcohol while taking Naltrexone?
While it's generally safe to drink alcohol while taking Naltrexone, it's not recommended. Naltrexone doesn't cause a severe reaction with alcohol like some other medications (such as disulfiram), but the goal of treatment is to reduce alcohol consumption.
If you do drink while taking Naltrexone, you may notice that you derive less pleasure from alcohol, which can help reduce the amount you drink over time. However, it's crucial to remember that Naltrexone doesn't prevent the intoxicating effects of alcohol or impair your judgment, so you can still become impaired if you drink.
Always follow your healthcare provider's advice regarding alcohol consumption during treatment.
Will Naltrexone affect my ability to drive or operate machinery?
Naltrexone itself doesn't typically cause drowsiness or impair cognitive function. However, some people may experience side effects like dizziness, especially when first starting the medication. It's advisable to see how Naltrexone affects you before driving or operating heavy machinery.
Remember, if you're taking Naltrexone for alcohol dependence and you consume alcohol, your ability to drive or operate machinery will be impaired by the alcohol, not the Naltrexone.
Can I take other medications while on Naltrexone?
Naltrexone can interact with certain medications, so it's crucial to inform your healthcare provider about all medications, supplements, and herbal products you're taking. This includes over-the-counter medications.
Particularly important interactions to be aware of:
- Opioid-containing medications (including some cough syrups and anti-diarrheal medicines)
- Thioridazine
- Yohimbine
- Disulfiram (in some cases)
Your doctor can advise you on potential interactions and may need to adjust your treatment plan accordingly.
How will Naltrexone affect my pain management if I get injured or need surgery?
Naltrexone blocks the effects of opioid pain medications, which can complicate pain management in case of injury or surgery. If you need medical treatment or surgery while taking Naltrexone, it's crucial to inform all healthcare providers involved in your care that you're on Naltrexone.
For minor pain, non-opioid pain relievers like acetaminophen or ibuprofen can be used. For more severe pain or surgery:
- Naltrexone may need to be discontinued temporarily (usually 72 hours before planned surgery)
- Higher doses of opioids may be necessary to overcome the blockade in emergency situations
- Regional anesthesia or non-opioid pain management strategies may be preferred
Always carry medical alert information indicating you're taking Naltrexone.
Can I get vaccinations while taking Naltrexone?
Yes, you can receive vaccinations while taking Naltrexone. There are no known interactions between Naltrexone and vaccines. However, as with any medical treatment, it's always best to inform your healthcare provider about all medications you're taking, including Naltrexone, before receiving a vaccination.
How will Naltrexone affect my mood and emotions?
Naltrexone itself doesn't typically have a direct effect on mood. However, as you progress in your recovery from alcohol or opioid dependence, you may experience changes in mood and emotions. These changes are often part of the recovery process rather than a direct effect of the medication.
Some patients report feeling more stable emotionally as their cravings decrease. Others may experience mood swings or irritability, especially in the early stages of treatment. If you experience persistent mood changes or depression, it's important to discuss this with your healthcare provider.
Can I take Naltrexone if I'm pregnant or breastfeeding?
The safety of Naltrexone during pregnancy and breastfeeding isn't fully established. If you're pregnant, planning to become pregnant, or breastfeeding, it's crucial to discuss this with your healthcare provider. They will help you weigh the potential risks and benefits of continuing Naltrexone treatment.
In some cases, the benefits of maintaining sobriety through Naltrexone treatment may outweigh potential risks to the fetus or infant. This decision should be made on an individual basis in consultation with your healthcare provider.
Dealing with Potential Side Effects
What are the common side effects of Naltrexone?
While many people tolerate Naltrexone well, some may experience side effects, especially when first starting the medication. Common side effects include:
- Nausea
- Headache
- Dizziness
- Fatigue
- Insomnia
- Anxiety
- Abdominal pain or cramps
These side effects are usually mild and often subside as your body adjusts to the medication. If side effects persist or become bothersome, consult your healthcare provider.
How can I manage nausea caused by Naltrexone?
Nausea is one of the more common side effects of Naltrexone, especially when first starting treatment. Here are some strategies to help manage nausea:
- Take Naltrexone with food or after meals
- Start with a lower dose and gradually increase as directed by your doctor
- Take the medication before bed if approved by your healthcare provider
- Stay hydrated and eat small, frequent meals
- Try ginger tea or ginger supplements, which can help alleviate nausea
- Consider over-the-counter anti-nausea medications if approved by your doctor
If nausea persists or is severe, contact your healthcare provider. They may adjust your dosage or recommend other strategies.
Can Naltrexone cause liver damage?
Naltrexone can affect liver function, and in rare cases, it may cause liver injury. However, serious liver problems are uncommon with the doses typically used for addiction treatment.
To monitor liver health:
- Your doctor will likely perform liver function tests before starting treatment and periodically thereafter
- The risk of liver problems is higher with larger doses (>50mg/day)
- Patients with pre-existing liver conditions require closer monitoring
If you experience symptoms like persistent nausea, abdominal pain, dark urine, or yellowing of the skin or eyes, contact your healthcare provider immediately.
Will Naltrexone affect my sleep?
Some people report sleep disturbances, including insomnia, when taking Naltrexone. However, it's important to note that sleep problems are also common during recovery from alcohol or opioid dependence, regardless of medication use.
If you experience sleep issues:
- Try taking Naltrexone in the morning instead of at night (if approved by your doctor)
- Practice good sleep hygiene (regular sleep schedule, avoiding screens before bed, etc.)
- Consider relaxation techniques like meditation or deep breathing exercises
- Discuss persistent sleep problems with your healthcare provider
Can Naltrexone cause depression?
Naltrexone itself is not typically associated with causing depression. In fact, some studies suggest it may have mood-stabilizing effects. However, mood changes, including depression, can occur during recovery from substance use disorders.
If you experience persistent feelings of sadness, hopelessness, or loss of interest in activities you once enjoyed, it's important to discuss this with your healthcare provider. These could be symptoms of depression, which is common in individuals recovering from addiction and may require additional treatment.
Are there any long-term side effects of Naltrexone?
Long-term studies of Naltrexone have not identified significant long-term side effects when the medication is used as prescribed. Most side effects, if they occur, tend to be most noticeable at the start of treatment and often subside over time.
However, as with any medication, long-term use should be monitored by a healthcare provider. Regular check-ups and liver function tests are typically part of ongoing Naltrexone treatment to ensure continued safety and effectiveness.
Can Naltrexone cause weight gain or loss?
Naltrexone itself is not typically associated with significant weight changes. However, some patients may experience changes in appetite or eating habits as they recover from alcohol or opioid dependence, which could lead to weight changes.
If you're concerned about weight changes during treatment, discuss this with your healthcare provider. They can help you develop strategies to maintain a healthy weight through proper nutrition and exercise.
Long-term Naltrexone Use and Treatment Outcomes
How long will I need to take Naltrexone?
The duration of Naltrexone treatment can vary widely depending on individual circumstances. Some people may take it for a few months, while others may benefit from longer-term use.
Factors that influence treatment duration include:
- The severity and duration of the substance use disorder
- Individual response to the medication
- Overall progress in recovery
- Presence of co-occurring mental health conditions
The decision to continue or discontinue Naltrexone should always be made in consultation with your healthcare provider. Abruptly stopping Naltrexone can increase the risk of relapse, so any discontinuation should be carefully planned and supervised.
Will Naltrexone cure my addiction?
Naltrexone is not a cure for addiction. It's a tool that can help manage cravings and reduce the risk of relapse when used as part of a comprehensive treatment program. Addiction is a complex, chronic condition that typically requires a multifaceted approach including:
- Medication (like Naltrexone)
- Behavioral therapy or counseling
- Support groups
- Lifestyle changes
- Treatment of co-occurring mental health conditions
Naltrexone can be a valuable component of this treatment approach, but it's most effective when combined with other forms of support and therapy.
What happens if I relapse while taking Naltrexone?
If you relapse while taking Naltrexone, it's crucial to be honest with your healthcare provider about what happened. A relapse doesn't mean treatment has failed; it's often part of the recovery process and can provide important information to adjust your treatment plan.
If you've taken opioids:
- Naltrexone can block their effects, potentially leading to taking dangerous amounts in an attempt to overcome this blockade
- This increases the risk of overdose, especially if Naltrexone is discontinued
If you've consumed alcohol:
- You may find that you derive less pleasure from drinking
- However, you can still become intoxicated and experience alcohol's harmful effects
Remember, a relapse is a signal to reach out for help, not a reason to give up on treatment.
Can I become addicted to Naltrexone?
No, Naltrexone is not addictive. It doesn't cause physical dependence, and it doesn't produce a "high" or any euphoric effects. This is one of the advantages of Naltrexone over some other medications used in addiction treatment.
When it's time to stop taking Naltrexone, you won't experience withdrawal symptoms from the medication itself. However, discontinuing Naltrexone should always be done under medical supervision to manage the potential increased risk of relapse to alcohol or opioid use.
How effective is Naltrexone in preventing relapse?
Naltrexone has been shown to be effective in reducing the risk of relapse for both alcohol and opioid use disorders. However, its effectiveness can vary among individuals.
For alcohol use disorder:
- Studies have shown Naltrexone can reduce the risk of returning to heavy drinking
- It may be especially effective in reducing cravings and the pleasure derived from alcohol
For opioid use disorder:
- Naltrexone can significantly reduce the risk of relapse when used as prescribed
- It's particularly effective when combined with counseling and support
Remember, Naltrexone is most effective when used as part of a comprehensive treatment program that includes therapy, support groups, and lifestyle changes.
Will Naltrexone affect my ability to feel pleasure from other activities?
Naltrexone is designed to block the effects of opioids and reduce the pleasure associated with alcohol consumption. It should not significantly affect your ability to derive pleasure from other activities like eating, exercise, or social interactions.
In fact, many patients report an improved ability to enjoy everyday activities as they progress in their recovery. This is often due to the reduction in cravings and preoccupation with substance use, allowing for greater engagement in and enjoyment of other aspects of life.
If you feel persistently unable to enjoy activities you previously found pleasurable, discuss this with your healthcare provider as it could be a sign of depression or another issue that needs attention.
Practical Aspects of Naltrexone Treatment
How much does Naltrexone treatment cost?
The cost of Naltrexone can vary widely depending on factors such as:
- Whether you're using the oral tablet or injectable form
- Your insurance coverage
- The pharmacy you use
- Whether you're eligible for any patient assistance programs
Oral Naltrexone is generally less expensive than the injectable form. Without insurance, a month's supply of oral Naltrexone can cost between $25 and $250. The injectable form (Vivitrol) is significantly more expensive, potentially costing over $1,000 per month.
Many insurance plans, including Medicare and Medicaid in some states, cover Naltrexone. Check with your insurance provider for specific coverage details. If cost is a concern, discuss this with your healthcare provider or a social worker, as there may be assistance programs available.
Can I travel with Naltrexone?
Yes, you can travel with Naltrexone. However, it's important to take some precautions:
- Keep the medication in its original container with the pharmacy label intact.
- Carry a copy of your prescription or a letter from your doctor stating that you're prescribed this medication.
- If traveling internationally, check the drug laws of your destination country, as regulations can vary.
- Pack enough medication to last your entire trip, plus a few extra days in case of travel delays.
- If you're using injectable Naltrexone (Vivitrol), plan your travel around your injection schedule.
Remember to store Naltrexone at room temperature and away from excessive heat, cold, or moisture.
Will Naltrexone show up on a drug test?
Standard drug tests do not typically screen for Naltrexone. It's not a controlled substance and doesn't cause intoxication, so most employers or organizations aren't looking for it.
However, if you're concerned about a drug test for any reason:
- You can disclose that you're taking prescribed Naltrexone to the testing facility.
- Provide a copy of your prescription if requested.
- In rare cases where Naltrexone might be detected, a medical review officer can verify its legitimate medical use.
Remember, taking Naltrexone as prescribed for addiction treatment is a positive step in recovery and is not viewed negatively in medical or employment contexts.
Can I drink non-alcoholic beer or use alcohol-containing products while on Naltrexone?
While Naltrexone is primarily used to treat alcohol dependence, it doesn't cause a severe reaction when alcohol is consumed like some other medications (such as disulfiram). Therefore, incidental exposure to small amounts of alcohol in products is unlikely to cause harm. However:
- Non-alcoholic beer often contains trace amounts of alcohol and could potentially trigger cravings in some individuals.
- Some mouthwashes, cough syrups, and other products contain alcohol. While the amount is usually small, it's best to choose alcohol-free alternatives when possible.
- Cooking with alcohol is generally considered safe as most of the alcohol evaporates during cooking.
Always follow your treatment plan and discuss any concerns about alcohol exposure with your healthcare provider.
How do I dispose of unused Naltrexone?
Proper disposal of unused medication is important for safety and environmental reasons. For Naltrexone:
- Check if your local pharmacy has a medication take-back program.
- Look for community drug take-back events, often organized by local law enforcement.
- If no take-back options are available, you can dispose of Naltrexone in household trash:
- Mix the medication with an undesirable substance like used coffee grounds or cat litter.
- Place the mixture in a sealed plastic bag or container to prevent the drug from leaking.
- Throw the container in your household trash.
- Remove or obscure all personal information on the empty medication bottle before disposing of it.
Do not flush Naltrexone down the toilet unless specifically instructed to do so by the medication guide.
Can I take Naltrexone if I have other medical conditions?
Naltrexone can be used safely by many people, but certain medical conditions may require special consideration:
- Liver Disease: Naltrexone is processed by the liver, so liver function should be monitored. People with acute hepatitis or liver failure should not take Naltrexone.
- Kidney Disease: While no dosage adjustment is typically needed, your doctor may monitor you more closely.
- Depression or Other Mental Health Conditions: Naltrexone isn't known to worsen depression, but any changes in mood should be reported to your doctor.
- Chronic Pain Conditions: Since Naltrexone blocks opioid receptors, it can complicate opioid-based pain management.
- Thrombocytopenia: Naltrexone may affect platelet function, so caution is advised in people with low platelet counts.
Always provide your healthcare provider with a complete medical history to ensure Naltrexone is safe and appropriate for you.
How does Naltrexone affect sexual function?
Naltrexone itself doesn't typically have a direct effect on sexual function. However, recovering from substance use disorders can impact sexual health in various ways:
- Some people may experience changes in libido or sexual function as their body adjusts to being substance-free.
- Psychological factors related to recovery can affect sexual relationships.
- If you were using alcohol or opioids to enhance sexual experiences, you may need to adjust to sexual activity without these substances.
If you experience persistent sexual problems during Naltrexone treatment, discuss this with your healthcare provider. These issues can often be addressed through counseling or other interventions.
Can I take herbal supplements or vitamins while on Naltrexone?
While Naltrexone doesn't have known interactions with most vitamins and herbal supplements, it's important to inform your healthcare provider about all substances you're taking. Some considerations:
- Some herbal products may affect liver function, which could potentially interact with Naltrexone metabolism.
- Supplements that have sedative effects (like valerian root or kava) should be used cautiously, as they may compound any drowsiness experienced as a side effect of Naltrexone.
- St. John's Wort, used by some for depression, can affect the metabolism of various medications and should be discussed with your doctor.
Always consult your healthcare provider before starting any new supplement while on Naltrexone.
How do I store Naltrexone properly?
Proper storage of Naltrexone helps maintain its effectiveness and safety:
- Keep Naltrexone at room temperature (68°F to 77°F or 20°C to 25°C).
- Store it away from direct light, heat, and moisture. Avoid storing in the bathroom.
- Keep the medication in its original container with the label intact.
- Ensure the cap is tightly closed.
- Keep Naltrexone out of reach of children and pets.
For injectable Naltrexone (Vivitrol), specific storage instructions will be provided by your healthcare provider or the administering clinic.
Can I chew or crush Naltrexone tablets?
It's generally recommended to swallow Naltrexone tablets whole with water. However, if you have difficulty swallowing pills:
- Check with your pharmacist or doctor if it's okay to crush the specific formulation you've been prescribed.
- If approved, you can crush the tablet and mix it with a small amount of food or liquid.
- Make sure to consume the entire mixture to get the full dose.
Never chew, crush, or break extended-release formulations unless specifically instructed by your healthcare provider, as this can affect how the medication is released in your body.
What should I do if I'm scheduled for a medical or dental procedure while taking Naltrexone?
If you're scheduled for any medical or dental procedure while taking Naltrexone:
- Inform all healthcare providers involved in your care that you're taking Naltrexone.
- This is especially important if the procedure might require pain management, as Naltrexone can block the effects of opioid pain medications.
- For planned surgeries, your doctor may recommend stopping Naltrexone 72 hours before the procedure.
- Carry medical alert information (like a card or bracelet) indicating you're taking Naltrexone.
- Discuss alternative pain management strategies with your healthcare providers in advance.
Never stop taking Naltrexone without consulting your prescribing doctor first.
How do I talk to friends and family about my Naltrexone treatment?
Discussing your treatment with loved ones can be challenging but can also provide valuable support:
- Educate yourself first: The more you understand about Naltrexone and your treatment, the better you can explain it to others.
- Be honest: Explain that Naltrexone is a medication that helps manage cravings and prevent relapse.
- Address misconceptions: Some people may not understand that Naltrexone is non-addictive and doesn't replace one drug with another.
- Set boundaries: You decide how much information to share and with whom.
- Seek support: Consider involving close family members in your treatment process if you're comfortable doing so.
- Direct them to resources: Share reputable information sources about Naltrexone if they want to learn more.
Remember, your treatment is personal, and you're not obligated to discuss it if you're not comfortable doing so.
Conclusion
Naltrexone can be an effective tool in the treatment of alcohol and opioid use disorders when used as part of a comprehensive treatment plan. While this FAQ covers many common questions, it's important to remember that every individual's experience with Naltrexone may be unique. Always consult with your healthcare provider for personalized advice and guidance throughout your treatment journey.
Your commitment to recovery, combined with the support of medication like Naltrexone and a strong treatment team, can pave the way for lasting positive change. Stay informed, stay engaged with your treatment, and remember that recovery is possible.
Glossary
- Addiction
- A chronic disorder characterized by compulsive substance use despite harmful consequences, leading to long-term changes in brain function and behavior.
- Alcohol Use Disorder
- A chronic condition characterized by problematic patterns of alcohol use leading to significant impairment or distress.
- Antagonist
- A substance that blocks or dampens the action of a receptor, often used to counteract the effects of other drugs or endogenous substances.
- Craving
- A strong desire or urge for a substance, such as alcohol or opioids, which can be a key factor in addiction and relapse.
- Dependence
- A state in which the body or mind has adapted to a drug, resulting in withdrawal symptoms when use of the drug is reduced or stopped.
- Detoxification
- The process of removing toxic substances from the body, often the first step in treating substance use disorders.
- Euphoria
- An intense feeling of pleasure or happiness, often associated with drug use, particularly opioids and stimulants.
- Naloxone Challenge Test
- A test used to determine if an individual is opioid-dependent before starting naltrexone, by administering naloxone and observing for withdrawal symptoms.
- Opioid
- A class of drugs that includes prescription pain relievers, heroin, and synthetic opioids like fentanyl, often associated with addiction and overdose.
- Opioid Receptors
- Proteins found on the surface of cells that opioids bind to in order to produce their effects, including pain relief and euphoria.
- Overdose
- An occurrence where an individual takes a substance in quantities greater than the body can process, leading to severe, often life-threatening effects.
- Relapse
- The return to substance use after a period of abstinence, often considered a normal part of the recovery process from addiction.
- Substance Use Disorder
- A condition in which the use of one or more substances leads to a clinically significant impairment or distress.
- Withdrawal
- Symptoms that occur when a person who is dependent on a substance reduces or stops its use, often including anxiety, nausea, sweating, and cravings.
References
Frequently Asked Questions for Naltrexone Patients
- Naltrexone Dosage Guide + Max Dose, Adjustments - Drugs.com
- What is Naltrexone? Side Effects, Uses, Dose & Risk - SAMHSA
- Naltrexone - StatPearls - NCBI Bookshelf - National Center for ...
Living with Naltrexone Treatment
- Naltrexone: 7 things you should know - Drugs.com
- Naltrexone for the Management of Alcohol Dependence
- Chapter 4—Oral Naltrexone - Incorporating Alcohol …
Dealing with Potential Side Effects
- Naltrexone side effects: What they are and how to manage them
- Naltrexone (Oral Route) Side Effects - Mayo Clinic
- Naltrexone: Uses, Dosage, Side Effects, Warnings - Drugs.com
Long-term Naltrexone Use and Treatment Outcomes
- Treatment outcomes of long-acting injectable naltrexone versus oral naltrexone in alcohol use disorder in veterans
- Treatment outcomes of long-acting injectable naltrexone versus …
- A Randomized Trial Comparing Extended-Release Injectable …