What’s It Like to Drink Alcohol While on Naltrexone?

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Naltrexone is increasingly popular as a solution for problem drinking. This medication blocks the endorphin rush from alcohol, helping you unlearn addictive drinking behavior, and ultimately either quit or return to moderate consumption. For some, this can feel like nothing short of a miracle—especially for those who struggle with cravings in recovery, or wish they could still have a drink at an important event.

But if you commit to taking this medication to treat alcohol use disorder, what can you expect it to feel like? After all, don’t most medications have some side effects? And if naltrexone affects the endorphin rush from alcohol, what will it feel like if you drink while taking it?

Here’s what to expect if you decide to try this approach—including what happens if you drink on naltrexone, how long it works, how naltrexone makes you feel overall, and whether it’s still possible to get drunk on the medication.

Read more: What is Naltrexone?

How Do You Take Naltrexone?

Naltrexone is usually taken as a tablet or as a monthly injection. The tablet (sold as ReVia or generically) is either taken once daily, or taken one hour before drinking (as per the Sinclair Method). The injection (Vivitrol) only needs to be taken once per month.

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Once naltrexone is in your system, as discussed above, it will block the endorphin rush from drinking alcohol. So, for example, if you plan to go out for the evening, you could take naltrexone one hour before you expect to have your first glass of wine. If you know that you drink every day, you could simply take one pill every morning. This will help reinforce the changes you are trying to make, while gradually rewiring your brain not to expect the same “buzz.”

Your doctor will supervise your treatment to determine how long you should take naltrexone. Typically, patients see the best results when they take the medication as needed for a few months or longer.

How Does It Feel To Drink After Taking Naltrexone?

Drinking on naltrexone will generally blunt the effects of alcohol. For example, after taking a tablet and having your first drink, the typical “buzz” may not arrive. Without the “reward” you usually get from drinking, your craving for another drink may diminish.

Many people say naltrexone lessens their enjoyment around drinking. One author told us he even poured half his glass of wine down the sink the first time he drank on naltrexone. It was that uninteresting. For others, the change takes longer. But most report that alcohol feels different, and they feel less motivated to drink it.

To give you a better idea of how naltrexone feels, here are some experiences reported from naltrexone reviews on Drugs.com:1

  • “I took the pill and of course, with a beer. I didn’t feel like having another beer for several hours. I was so thirsty though and began drinking tons of water that day.”
  • “Day 1 took 50mg, felt a bit strange but then noticed cravings went away.”    
  • “I have noticed the buzz is disappearing and it just tastes like, well, nothing really.” 
  • “It just is kind of unappealing now… I feel slightly nauseous sometimes but it’s not overwhelming and I’m not eating as much food either.”
  • “The feeling I usually get when I have a drink is ‘full’ and I can drink no more. This has also decreased my cravings greatly.” 
  • “I got the script filled (50mg), went home, took it, felt nothing, went to bed. I kept taking it daily, nothing for the first week. But then it occurred to me that I had thought about drinking much less than normal.”

Read more Naltrexone Reviews

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Does Naltrexone Make You Sick If You Drink?

No. Unless you have an adverse reaction to the medication, naltrexone should not make you feel ill at all. The only way to feel sick when drinking on naltrexone is to drink too much alcohol—which would make you feel sick anyway.

There is another medication that does intentionally make you feel ill when you drink. It’s called disulfiram (often sold as Antabuse), and it works as a form of aversion therapy. Drinking on Antabuse give you an almost-instant severe hangover, which can essentially block you from relapsing.

Antabuse is a much harsher form of treatment, and is becoming less popular as other options emerge.

How Long Does Naltrexone Block Alcohol For?

Naltrexone is effective for around four to 13 hours after you take it.2 This is also its half-life—meaning how long it stays in the body before only half is left. You can therefore typically take it before drinking and have it last the entire night—which is why only one tablet a day is usually prescribed. Waiting one hour for full effect after taking it is recommended.

How Long Does Naltrexone Last in the Body?

Naltrexone’s half-life in the body is up to 13 hours, but it can take longer for the entire dose to leave your body. It generally takes a few half-lives until naltrexone is fully eliminated.

How long naltrexone stays in your body depends on a few factors, such as:

  • Metabolism— Bodies with faster metabolisms will eliminate drugs quicker. 
  • Weight— Having a higher percentage of fat can affect medication distribution and metabolism.
  • Age— Younger bodies typically process drugs faster. 
  • Overall health— Some health issues or chronic illnesses can affect how long drugs stay in the body.
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How Does Naltrexone Make You Feel in General?

Naltrexone is not addictive or psychoactive, meaning that it won’t give you any type of high. And stopping naltrexone won’t cause any withdrawal symptoms. This is one of the reasons why it can be a great treatment option.

Most people who take naltrexone don’t experience significant side effects. A person’s mood, digestion, cognition, and interest in other daily activities are usually unchanged. Some people experience nausea, headaches, or fatigue as they adjust to the medication, but this generally clears up after a week or so.

That said, up to 10 percent of people will experience stronger side effects, including what some describe as an odd feeling of intoxication, and/or more persistent digestive issues. These individuals may need to take a different medication to control their alcohol use.

Dr. John Mendelson of Ria Health answers Common Questions about Naltrexone Side Effects

Does Naltrexone Affect Other Pleasures?

For the most part, no. When it comes to blocking endorphins, naltrexone seems to distinguish between external and internal stimuli. This means the pleasures of exercise or sex are generally unaffected, and in some cases even increase.

However, naltrexone may block the reward you get from other addictive behaviors besides alcohol. It has been used as a weight loss drug, because it can reduce the pleasure from binge-eating. It has also been used to treat pornography and gambling addiction.

This means that if you struggle with other addictive behaviors aside from alcohol use, you may find less pleasure from those as well. But you shouldn’t feel less pleasure from ordinary activities. In the rare case that this happens, this is an adverse reaction to the medication, and a reason to stop taking it. Once the medication leaves your system, your reactions should return to normal.

Does Naltrexone Impact Your Mood?

For a minority of patients, naltrexone can cause mood changes, but in most cases the answer is no. Naltrexone does not directly affect serotonin or dopamine—two chemicals that help regulate emotions. And, as mentioned above, it seems to only act on the endorphin rush from external stimuli, such as alcohol or drugs. Most of the ordinary joys of life are unaffected.

There are rare cases in which naltrexone can cause anhedonia, or lack of overall pleasure, leading to depressive symptoms. In this case, you should stop taking the medication. But this is not common, and research suggests naltrexone may even reduce depression for some people.3

Can You Still Get Drunk on Naltrexone?

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Photo by ELEVATE on Pexels

Yes. It’s important to point out that naltrexone doesn’t stop impairment. Most people who take naltrexone still experience a sense of intoxication when they drink—they just don’t experience the same “reward” from that intoxication. In other words, you can still get drunk on naltrexone, and experience impaired coordination or judgment—you just probably won’t enjoy it as much.

It goes without saying, therefore, that you shouldn’t drive when drinking on naltrexone, or perform any other activity that requires good coordination and judgment. It’s important to take the usual safety precautions if you consume alcohol. And yes, you can still experience a hangover as well.

Drinking Alcohol on Naltrexone: The Takeaway

To a large degree, naltrexone helps change your drinking patterns because it changes how you feel when you drink alcohol. The most notable effect of naltrexone is that it reduces alcohol’s “buzz.” Other than that, many people don’t feel anything different. However, over time, they’ll notice that their cravings diminish. Some people may experience side effects as their body gets used to naltrexone. The drug also does not stop impairment, even though you may not feel drunk in the same way.

Before starting naltrexone treatment, it’s important to read more about the drug in general, and to consult with a medical professional. This is especially important if you have health problems linked to drinking alcohol, or are taking any kind of opioid medication, which will also be blocked by naltrexone.

Naltrexone is also most effective as part of a broader treatment plan, including medical supervision and counseling. Ria Health offers customized care plans, experienced recovery coaches, and access to licensed physicians, all via telehealth. It’s convenient, stigma-free, and if naltrexone doesn’t work for you, we can prescribe several alternatives. Schedule a call with one of our counselors to learn more.


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Written By:
Ria Health Team
Ria Health’s editorial team is a group of experienced copywriters, researchers, and healthcare professionals dedicated to removing stigma and improving public knowledge around alcohol use disorder. Articles written by the “Ria Team” are collaborative works completed by several members of our writing team, fact-checked and edited to a high standard of empathy and accuracy.
Reviewed By:
Evan O'Donnell
Evan O’Donnell is an NYC-based content strategist with four years’ experience writing and editing in the recovery space. He has conducted research in sound, cognition, and community building, has a background in independent music marketing, and continues to work as a composer. Evan is a deep believer in fact-based, empathic communication—within business, arts, academia, or any space where words drive action or change lives.
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