The People's Perspective on Medicine

Naltrexone for Alcohol Problem: Will It Work?

Almost everyone has been touched by an alcohol problem. A friend or family member may be susceptible. Is there a drug that can help overcome alcohol dependency? What about naltrexone?

Americans have an alcohol problem. Most people think alcohol abuse is someone else’s problem. The guy on the street corner begging for money, perhaps. Not the upstanding citizen who drives a nice car and has a lovely family. In reality, though, alcohol now affects one out of eight American adults (JAMA Psychiatry, Sept. 2017). Alcoholism is on the rise. Is there anything that can help?

Can Naltrexone Help an Alcohol Problem?

Q. I have been a heavy drinker for 35 years—just in the evenings, after work. I would take 6 or 8 drinks nightly, waking with a hangover almost every morning.

I spoke to my doctor last year about naltrexone. Since starting naltrexone, I have been able to manage my drinking. I limit it to no more than 1 to 2 drinks daily.

On some days, I have skipped alcohol completely. My prescription ran out a couple of months ago. At first, I was able to limit my intake. However, it has increased to the point where I am returning to my previous consumption levels.

I will be seeing my doctor in a few days and, as much as I hate relying on a drug for help, I will be asking for a renewal on the naltrexone prescription.

A. Naltrexone (ReVia, Vivitrol) is an opioid antagonist. That means it blocks the effects of opioid medication as well as natural opioids (endorphins) in the brain. Scientists think it is these endorphins that are responsible for the pleasure some people get from drinking alcohol.

Studies show that naltrexone can be effective, especially when combined with counseling (New England Journal of Medicine, Aug. 14, 2008; Journal of Substance Abuse Treatment, Feb. 2018).

Another Reader’s Experience:

Carl shares his naltrexone story:

I am a 62-year-old male emergency room nurse with a history of drinking 6 to 8 alcoholic drinks a day for the past 30 years or so. My drinking is confined to the hours between 5 and 10 PM. My motivation for drinking is I like the “buzz”. I honestly don’t believe my alcohol use is a coping mechanism, as both my personal and professional life is very satisfying and successful.

“I do however have an addictive personality. (I was a 2 to 3 pack a day smoker until 20 years ago when I stopped cold turkey). I have no desire to stop drinking, but I realize that if I continue my present rate of consumption I will sooner or later suffer health problems. I just want to reduce my consumption to a reasonable level.

“I heard an interview with Dr. Eskapa on NPR and bought and read his book (The Cure for Alcoholism: Drink Your Way Sober Without Willpower, Abstinence or Discomfort). I started on naltrexone on January 5th.

“I could become the poster child for this drug. In the 3 weeks I have been taking it, I’ve had 1 to 3 drinks a day (usually 2), and have suffered absolutely no side effects. Indeed, the subtitle to the book (Without Willpower, Abstinence or Discomfort) has proved 100% true.

“I realize I am still very early in the game, but I am absolutely convinced that this is a life changer for me. I have spoken to a number of my friends and coworkers about naltrexone and am amazed at the interest they have shown, either for themselves or their loved ones.

“If the drug continues to be as successful as it appears to be over the next 3 to 4 months, I intend to very actively and publicly promote its use. I would very much like to learn of other peoples experience with naltrexone.”

Not everyone will solve an alcohol problem with naltrexone. Nevertheless, some people do discover that their cravings are diminished. We share Carl’s interest in hearing from others who have had experience with naltrexone, either positive or negative. Share your story in the comment section below.

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    About the Author
    Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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    Curious if any readers might help me by sharing when they administer their low dose naltrexone (LDN) do you take it every morning or before going to bed? I read one place online that when using naltrexone to assist with inhibiting alcohol consumption that it is recommended to take your LDN one hour before planning to have your first drink, is this the best protocol? It seems that might be the best course if the LDN has a short 4 to 5 hour effective life span. Also does one consider is a low dose a 1/2 50mg tablet or 1/4 tablet, maybe that is just something that is based on individual need and trail. Appreciate anyone’s assistance as I have not yet started my treatment course with LDN.

    I really want to believe naltrexone works but am still struggling. The first 4 days were great with no interest in drinking. But the last two days I’m back to my bottle of wine a day habit.
    I felt so much better about not drinking for those few days. Am I relying too much on the meds?

    I know VIVITROL does work because I drank for over 30 years and couldn’t stop on my own. I started on the VIVITROL shot over a year ago and I am convinced that it works wonders. I just don’t know what to say, but try it. You have nothing to lose, please.

    Its great to see medically assisted strategies to help curb and cause cessation in addiction. The science behind addiction is being translated for drug development and application. Suboxone and methadone help w opioid addiction. Importantly, taking ldn or any other drug is in itself not a totally encompassing strategy. It seems, that is evidence based criteria, indicates that several strategies combined may work best. strategies like cognitive behavioral therapy, dialectical behavioral therapy etc. Addiction is complex and an evolving field. Trauma often is the basis for addiction and this can be discovered and resolved through the embodied strategies of somatic emergence and other modalities. Essentially, addiction is a brain based disease but combining medical assisted strategies(like ldn, suboxone etc) that have biological basis w the power of mindfulness can help many overcome the lingering behavioral consequences of the unresolved past, stresses of the present and create the promise of a future that is supported by a skillset of resilency, determination and hope.

    Alcoholism is NOT a disease – it’s an addiction like any other addiction. Diseases are caused by germs. Alcoholism is only called a disease because alcohol is acceptable in our society while hard drugs are not. If we treat this and all addictions as the medical problems they are, we could actually help people. Blaming addicts for their addiction is not helpful.

    “The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. The American Medical Association (AMA) had declared that alcoholism was an illness in 1956.” Get the facts.

    I remember some years ago reading about LDN for people with Multiple Scelosis (MS) and finding it used in all kinds of chronic problems. You should do a longer article on it.
    Interesting about the alcohol. I am not and never have been a drinker. If I drink one glass of wine I talk too much for 5 minutes then fall asleep. It does not give me any kind of buzz. My father has the same effects, which as a man in a drinking profession in a wine at every meal country gets him thought of as a drunk. (If he says ‘water only’ others think he’s drying out. You can’t win in Europe) I only once have met someone else with this exaggerated response to alcohol. I wonder what LDN would do to us?

    I learned years ago that alcoholism and diabetes are 2 ends of a very long problem related to insulin production. What I was told was that alcoholics have excessive insulin production and diabetics have insufficient insulin production. That is a condensed explanation, of course, but I’d like to know what you know about this and how much of it relates to these two issues.

    It has been stated that the alcoholic wants to do everything possible to control or quit drinking except quit drinking. Alcohol is a drug and using one drug to try to control the overuse of another seems futile to me.
    It has also been said that only an alcoholic has to continually try to control his or her drinking, usually with little or no success.
    All of my self reliance and will power was useless when the desire to drink/use took control. The only thing that has worked for me for 25 years is AA/NA.

    I was prescribed low dose naltrexone (LDN) for my rheumatoid arthritis. I was told there are no side effects however it was not for me. I found I could not stay awake all day. I would need to go to sleep at 3:00 or 4:00 in the afternoon for a nap. The doctor couldn’t understand why it affected me that way. I asked to be taken off the LDN and don’t need those naps any more. Could I have had a sensitivity to this medication?

    I was told by my PCP, when I asked what in the world caring, responsible adults were supposed to do, to cope with life altering chronic pain levels and no relief to be had, now that everyone is being denied adequate pain control, that “People were going to have to start drinking.”
    Can you believe this?
    I don’t drink.

    For me, the key has been to use the Naltrexone along with cognitive therapy and meditation for my anxiety. I also had to cut the doses in half because the full dose makes me sick (nausea, dizziness). Overall based on my experience- I’d recommend to anyone who is looking for a solution to end their drinking problem. Oh- and search for another doctor if your present doctor will not prescribe it to you. Most doctors have not even read the research behind this drug and are in the dark regarding Naltrexone.

    I am interested in hearing more about people’s experiences and if anyone met resistance from a doctor when they asked for a prescription.

    Drinking alcoholic beverages without impunity: The goal of every drunk. And now a medication to potentially make that misguided wish come true. The testimonials featured in this article are further proof that alcoholism is a disease of denial.

    An emotional topic for me, for sure. I should have used the word “heavy drinker” instead of “drunk.” I stand by the rest of my thoughts shared on this article.


    Tracey R.

    I was a very heavy daily drinker. I tried Naltrexone and found that it helped me moderate my drinking. There were sometimes days when I wouldn’t have any interest in alcohol and would abstain without cravings.

    However, after a few months of these good results, I found that when I did drink, the Naltrexone diminished the pleasure I took from drinking. Instead of drinking less, I became selective about when I used Natrexone. When I wanted a good buzz, I skipped it, and eventually stopped using it altogether.

    Shortly afterwards, my drinking came to a crisis point. I decided that working with AA for complete abstinence was the only thing that would work for me. I’ve been sober for over 3 years now.

    This is not to discount successful use of Naltrexone by others, but only to point out that there are pitfalls to be aware of, such as the possibility of reduced pleasure. And like all drugs, it won’t work if you don’t take it.

    Not sure about the correlation between alcohol consumption and naltrexone, but I have been on low-dose naltrexone 4.5 mg for 6 years now. I was given this drug to help me manage the side effects of Levaquin toxicity syndrome, Hashimoto’s disease and Lyme disease as I was getting sick all of the time. This drug has literally been a lifesaver for me as I have been sick only twice since I started taking the drug as it has boosted my immune system so well. However, I can understand how it would be helpful in treating alcohol overuse (since none of the above people want to admit they have a problem) because when I was given opioids after breaking my ribs, they were ineffective until I went off the LDN for a few days. I think the half-life of this drug is 24 hours, but it took at least 2 days to be out of my system.

    I also have a heavy drinking friend who I suggested he give Naltrexone a test drive. He told me he can’t drink more than one drink on it. You still get a buzz. It just doesn’t drive you to jump to the bottom of the bottle in one sitting.

    LDN lasts for about 4 hours in the body. It suppresses the opioid receptors for a short time and then accelerates the production of endorphins. That’s why it’s given in such low doses.

    My world changing experience mirrors the two in this article. My doctor was not keen on renewing my prescription until I shared my positive experience and showed him the chapter directed to the medical profession from that book The Cure For Alcholism mentioned above. The chapter is available online.

    * Be nice, and don't over share. View comment policy^