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 from time to time. Abstinence is not required – you can drink on naltrexone.
Before you decide to take naltrexone it is important to understand how it works, what you can expect, and if it’s the right solution for you. Here we will address those topics and many of the questions you may have about naltrexone.
Read more: What is Naltrexone?
How Do You Take Naltrexone and What Dosage is Effective?
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.
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 drink.
If you usually drink daily, you could 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 can determine the correct dosage and 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.
For naltrexone to be effective, it’s essential to take it as directed. Some people may miss doses because they forget, or do so intentionally because they want to feel more of a buzz when drinking. Doing this will hinder the effectiveness of the medication.
How Does It Feel To Drink After Taking Naltrexone?
Taking naltrexone will generally blunt the enjoyment of alcohol. 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.
One patient commented that he 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. However, most report that alcohol feels different, and they feel less motivated to drink it.
- “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
Will Naltrexone Make You Sick If You Drink?
Unless you have an adverse reaction to the medication, naltrexone should not make you feel ill at all. However, you may feel sick if you drink too much while taking naltrexone.
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 gives 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 the Effect of Naltrexone Last?
Naltrexone is effective for around four to 13 hours after you take it. This is known as the half-life of naltrexone—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 Stay in Your System?
As mentioned previously naltrexone’s half-life in the body is up to 13 hours, but it can take longer for the entire dose to leave your system. It generally takes a few half-lives until naltrexone is fully eliminated.
How long naltrexone stays in your body depends on several factors, such as:
- Metabolism— Bodies with faster metabolisms will eliminate drugs more quickly.
- 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?
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 of binge eating. It has also been used to treat pornography and gambling addiction.
If you do experience less pleasure in normal activities (which is rare) 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 it does not. Naltrexone does not directly affect serotonin or dopamine—two chemicals that help regulate emotions.
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. However this is not common, and research suggests naltrexone may even reduce depression for some people.
Can You Still Get Drunk on Naltrexone?
Yes. It’s important to point out that naltrexone doesn’t stop impairment from drinking. Most people who take naltrexone still experience a sense of intoxication in terms of the physical effects of alcohol 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, as well as hangovers. Therefore, it’s important to take the same safety precautions when you consume alcohol as you would if you were drinking without taking naltrexone.
What is the Success Rate of Naltrexone?
Naltrexone has a long track record in effective addiction treatment. It has been FDA-approved to treat opioid addiction since the 1980s, and approved to treat alcohol use disorder (AUD) since 1995.
Research indicates that naltrexone effectively reduces heavy drinking and cravings, and decreases the chance that someone will return to unhealthy drinking behaviors. Exact success rates vary, but the Sinclair Method, which uses naltrexone, has a 78 percent success rate.
Naltrexone is known to be more effective when taken as part of a holistic program that includes recovery coaching and counseling. It is important to address the root causes of your drinking and develop healthy habits and coping mechanisms.
How Long Does Naltrexone Take To Work?
The pill takes about one to two hours to fully start working. In some cases, people experience improvement the first time they take naltrexone, but it usually takes some time for the medication to completely eliminate alcohol cravings.
Naltrexone and The Sinclair Method
The Sinclair Method has been proven effective in more than 90 clinical trials worldwide and is noted to be successful for approximately 80 percent of problem drinkers. It is recognized as the standard treatment for alcohol dependence in several European countries.
People on the Sinclair Method are instructed to take a single dose of naltrexone one hour before drinking. Once this dose takes effect, they are free to consume alcohol if they want to.
If they drink a large amount after taking naltrexone, they may still feel the negative impacts of being drunk such as reduced motor control. But many report that drinking on naltrexone isn’t as satisfying and over time the desire to drink is reduced.
Will Naltrexone Affect My Hormones?
According to the National Institute of Health naltrexone and other opioid antagonists can have an effect on the secretion of sex hormones for both males and females at the early follicular phase. More research is needed regarding the consequences. Therefore it is important to speak to your physician to weigh the pros and cons of the medication for you.
How Long Will I Need to Stay on Naltrexone?
Your physician will determine how long you should take the medication. Typically, people experience the best results when they take naltrexone as needed for a few months or longer.
Without the “reward” that alcohol brings, some people lose their motivation to drink. They may then taper off and finally quit.
However without counseling in conjunction with the medication the desire to drink may resurface in the presence of certain emotions or triggers.
Before starting naltrexone treatment, it’s important to read more about the drug and to consult with a medical professional. This is especially important if you have health problems linked to drinking alcohol such as liver disease, or are taking any kind of opioid medication, which will also be blocked by naltrexone.
How to Get the Best Results With Naltrexone
As mentioned earlier naltrexone is 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, and 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.