What is Naltrexone?
Common Brand Names: Revia, Vivitrol
Naltrexone is an opioid antagonist, which means it blocks the effects of opioids at opioid receptors. When the antagonist is in the body, opioid agonists like morphine, heroin, or fentanyl cannot bind to opioid receptors because its molecule is in the way. Thus, naltrexone blocks the intoxicating effects of opioids; it also prevents people from becoming physiologically dependent. Consequently, naltrexone is a powerful treatment option for people with opioid use disorder.
How is naltrexone used in opioid use disorder?
Naltrexone helps prevent relapse in people that struggle with opioid use disorder who are in the phase of recovery. Although, people should only use this medication if they have completed medically supervised detox from all opioids. Patients must first “reset” the way their bodies use and react to opioids. This is accomplished through a medically supervised withdrawal of opioids. It not only clears the body of the drug but also allows the body to adjust to living without opioid drugs.
“It is critical that patients with opioid use disorder successfully complete medically supervised detox before they begin taking naltrexone. The medication may cause an immediate “precipitated” withdrawal in someone who is still physically dependent on opioids. Precipitated withdrawal is a quick, extremely intense form of opioid withdrawal, which can be dangerous. Precipitated withdrawal causes agitation, changes in consciousness, nausea, vomiting, abdominal pain, rapid heart rate and other symptoms. Additionally, patients must be completely opioid-free before starting naltrexone, which can only begin after an effective detox.”
Unless patients have gone through a proper rapid detox, healthcare providers will use something called a naloxone challenge. The test determines whether a person is ready for naltrexone use (no longer physically dependent on opioids) without triggering a precipitated withdrawal. Naloxone is also an opioid antagonist; however, but very short acting—it lasts only minutes.
In the naloxone challenge test, a healthcare professional injects naloxone into the patient and carefully watches vital signs such as heart rate and blood pressure while monitoring the patient for symptoms and signs of withdrawal. If patients do not display any significant signs of opioid withdrawal, they pass the naloxone challenge test. On the other hand, patients who exhibit signs of withdrawal will need to wait 24 hours to start naltrexone or retest. The reason they use naloxone for this test is that because it’s short-lived, any withdrawal symptoms that it causes are also short-term.
“In summary, any patient who is going to take Revia or Vivitrol, should do so under the close supervision of medical staff after going through medically supervised opioid detox. When used properly, these drugs are remarkably safe.”
What are the different forms of FDA approved naltrexone?
Naltrexone comes in two forms: oral or injection (Vivitrol). Most patients take oral form every day, which comes in a 50mgs dose. The treating physician can alter dosages. By contrast, a patient only takes one injection of Vivitrol every four weeks. A healthcare provider usually administers the injectable Vivitrol (also called depot or extended-release injectable ). They inject it into a muscle with a needle and syringe.
For this type of medication to work, patients must take it faithfully. This can be difficult for people who are battling addiction. One common strategy is for healthcare providers to provide injectable Vivitrol for the first few months and then transition to the oral form of the medication. This approach allows people with opioid use disorder to focus on their early recovery with less fear of relapse, but then move to a potentially more convenient way of taking the medication at later stages of their recovery. On the other hand, some people prefer to continue taking the injectable form, since it only requires one treatment per month rather than a treatment every day. Your opioid use disorder doctor can help you decide what is right for you.
What are the side effects of naltrexone?
Naltrexone has very few side effects. Uncommonly, people will report nausea, headaches, dizziness, or fatigue. In rare cases, people taking very high dosages can develop liver problems; however, these problems resolve once they stop taking the medication.
Is naltrexone a narcotic and is it addictive?
In a word, no. Naltrexone is not an addictive drug. People become addicted or dependent on opioid agonists, not antagonists. Becoming addicted to this medication is impossible. Furthermore, when discontinued, there are no withdrawal symptoms.
What if I relapse?
Naltrexone blocks opioid receptors. Therefore, if you are taking an antagonist, opioids should not affect (they do not create a “high” or pleasurable and sensations). Unfortunately, some people do stop taking naltrexone and start using opioids again. If this occurs, it’s important to remember that your body can’t tolerate the high doses of opioids you previously took. If someone stops taking against medical advice and chooses to abuse opioids again, there is a high risk of opioid overdose.
What is a Naltrexone therapy?
Waismann Method Rapid Detox has been detoxing patients from opioid drugs for nearly 20 years, with over a 98% success rate. As described above, Naltrexone is a non-addictive medication which blocks the opiate receptors, which means, it virtually eliminates physical cravings.
The length of time a patient will receive a Naltrexone therapy is discussed and evaluated by the treating physician. This medication has helped thousands of patients feel craving free, so they can better focus on the emotional and social aspects of their lives.