How Naltrexone Works: Experts Point of View
As the Chief Medical Officer of Ria Health, I’ve spent years helping people reduce or quit drinking using evidence-based tools. One of the most effective medications we use is naltrexone. Here, I’ll explain exactly how it works, who it’s for, and why it’s a game-changer in alcohol treatment.
What Is Naltrexone and How Does It Work?
Naltrexone is an FDA-approved medication used to treat alcohol use disorder (AUD). It works by targeting the brain’s reward system. When you drink alcohol, it releases endorphins that activate opioid receptors in your brain. This process creates feelings of pleasure and relaxation, reinforcing the urge to drink.
Naltrexone is an opioid receptor antagonist, meaning it blocks these receptors. When alcohol can’t activate them, the “reward” you usually feel from drinking is significantly reduced. Over time, this helps break the cycle of craving and overconsumption.
How Does Naltrexone Affect Drinking?
Naltrexone doesn’t make you sick if you drink—it’s not like disulfiram (Antabuse), which creates an aversive reaction to alcohol. Instead, it reduces the enjoyment you get from drinking. Many people report feeling “neutral” about alcohol, which makes it easier to cut back or stop altogether.
At Ria Health, we’ve seen members reduce their drinking days by an average of 50% in just a few months. Heavy drinking episodes often drop by as much as 60%, and some members report that cravings disappear entirely.
Who Can Benefit From Naltrexone?
Naltrexone is effective for people with AUD who want to reduce their drinking or quit entirely. It’s particularly helpful for those who struggle with cravings or feel like drinking is controlling their lives.
One of the benefits of naltrexone is that it supports both abstinence and harm reduction. If your goal is to drink less rather than quit completely, naltrexone can help you regain control by making alcohol less appealing.
How Do You Take Naltrexone?
Naltrexone is typically prescribed in tablet form, with a standard dose of 50 mg per day. Your doctor may start you on a lower dose to ensure you tolerate the medication well and gradually increase it to the full dose.
Here’s how the process usually works:
- Initial Dosing: Most people begin with a smaller dose, such as 12.5 mg, to minimize potential side effects. Once tolerance is confirmed, the dose is adjusted to 50 mg daily.
- Daily Administration: Naltrexone should be taken at the same time each day, ideally in the morning or as directed by your doctor. Consistency is key for maintaining its effectiveness.
- Duration of Use: The length of time you take naltrexone depends on your goals and progress. Many people use it for 6 months, but others benefit from continuing for a year or longer, especially if cravings persist or their drinking habits are deeply ingrained. Your doctor will work with you to decide when it’s appropriate to stop.
- Stopping the Medication: Once you’ve reached your treatment goals—whether that’s reducing drinking or maintaining abstinence—naltrexone can often be discontinued under medical supervision. By this point, your brain has likely had time to “rewire” its response to alcohol, reducing cravings naturally.
At Ria Health, we tailor the dosing approach to fit each person’s unique goals and lifestyle.
Are There Side Effects of Naltrexone?
Like any medication, naltrexone can cause side effects, though most people tolerate it well. Common side effects include nausea, fatigue, and headache, which typically improve after the first few days. Serious side effects are rare, but your doctor will monitor you closely to ensure it’s the right fit.
Is Naltrexone Backed by Science?
Yes, naltrexone is one of the most researched medications for AUD. Studies consistently show it reduces heavy drinking and improves outcomes for people with AUD. At Ria Health, we’ve prescribed naltrexone to thousands of members, collecting extensive real-world data that mirrors the clinical research. Our results show significant reductions in drinking and a high rate of satisfaction among members.
How Does Naltrexone Fit Into a Larger Treatment Plan?
While naltrexone is highly effective on its own, it works best as part of a comprehensive treatment plan. At Ria Health, we combine naltrexone with:
- Behavioral Coaching: Certified coaches help members set goals and navigate challenges.
- Technology: Tools like a Bluetooth breathalyzer and progress tracking keep members motivated.
- Telehealth Access: Members can connect with medical professionals and coaches anytime from the comfort of home.
This integrated approach ensures that members not only take naltrexone but also have the support they need to succeed.
What Is It Like to Use Naltrexone?
Many of our members describe a profound shift in how they feel about alcohol. One person shared, “I used to feel like I couldn’t say no to a drink. Now, I don’t even think about it.” Another reported that it gave them the “pause” they needed to make more intentional choices about drinking.
This sense of control is one of the most empowering aspects of naltrexone—it helps people move from feeling powerless to confident about their ability to change.
Why Naltrexone Matters in Modern Alcohol Treatment
As someone who has prescribed naltrexone for over two decades, I can confidently say it’s one of the most effective tools we have for treating alcohol use disorder. But it’s not just the medication—it’s the way we use it. At Ria Health, we’ve built a program that combines naltrexone with cutting-edge technology and personalized care. Together, these elements create lasting change.
If you’ve been struggling with your relationship with alcohol, know that science-backed solutions like naltrexone are available. With the right tools and support, you can take back control and live a healthier, more fulfilling life.
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