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Naltrexone in alcohol dependency treatment

Naltrexone is a type of drug ( in the form of tablets, injections and implants) that is prescribed to alcohol dependent people to help them reduce cravings, control or abstain from drinking. The drug is an opioid receptor antagonist that primarily treats alcoholism and opioid dependence. Naltrexone has proven to be an effective anti-addiction drug for many people. Used in conjunction with other medications, Naltrexone can greatly improve the outcomes for alcoholics and alcohol dependents.

Why does naltrexone help for alcoholism?
While the precise mechanism of action for naltrexone's effect is unknown, reports from successfully treated patients suggest three kinds of effects. First, naltrexone can reduce craving, which is the urge or desire to drink. Second, naltrexone helps patients remain abstinent. Third, naltrexone can interfere with the tendency to want to drink more if a recovering patient slips and has a drink.

Is Naltrexone sufficient to achieve the maximum results in alcohol dependency treatment?
No, naltrexone is only one component of a program of treatment for alcoholism including counseling; help with associated psychological and social problems and participation in self-help groups. In both studies where naltrexone was shown to be effective, it was combined with treatment from professional psychotherapists.

How long does naltrexone take to work?
Naltrexone's effects on blocking opioids occurs and hour  after taking the first dose. Findings to date suggest that the effects of naltrexone in helping patients remain abstinent and avoid relapse to alcohol use also occur early.

When may Naltrexone be administrated?
Naltrexone should not be used with pregnant women, individuals with severe liver or kidney damage or with patients who cannot achieve abstinence for at least 3 days prior to initiating medications. Also, people who are dependent on opioid drugs, like heroin or morphine must stop their drug use at least 7 days prior to starting naltrexone.

Does one need to get blood tests while I'm on naltrexone? How often?
To ensure that naltrexone treatment is safe, blood tests should be obtained prior to initial treatment. Following that, retesting generally occurs at monthly intervals for the first three months, with less frequent testing after that point. More frequent testing may be requested depending on the health of your liver prior to beginning treatment. Blood tests are needed to make sure that liver function is adequate prior to taking naltrexone and to evaluate whether naltrexone is having adverse effects on the liver.

Can one take other medications with naltrexone?
The major active effect of naltrexone is on opioid drugs, which is one class of drugs used primarily to treat pain but is also found in some prescription cough preparations. Naltrexone will block the effect of normal doses of this type of drug. There are many non-narcotic pain relievers that can be used effectively while you are on naltrexone. Otherwise, naltrexone is likely to have little impact on other medications patients commonly use such as antibiotics, non-opioid analgesics (e.g., aspirin, acetaminophen, ibuprofen), and allergy medications. You should inform your physician of whatever medication you are currently taking so that possible interactions can be evaluated. Because naltrexone is broken down by the liver, other medications that can affect liver function may affect the dose of naltrexone.

Will one get sick If I drink while on naltrexone?
No. Naltrexone may reduce the feeling of intoxication and the desire to drink more, but it will not cause a severe physical response to drinking.

Will one get sick If I stop naltrexone suddenly?
Naltrexone does not cause physical dependence and it can be stopped at any time without withdrawal symptoms. In addition, available findings regarding cessation do not show a “rebound” effect to resume alcohol use when naltrexone is discontinued.

What Is the relationship of naltrexone to AA?
There is no contradiction between participation in AA and taking naltrexone. Naltrexone is not addictive and does not produce any “high” or pleasant effects. It can contribute to achievement of an abstinence goal by reducing the craving or compulsion to drink, particularly during early phases of recovery. It is most likely to be effective when the patient's goal is to stop drinking altogether.

How long should one stay on naltrexone implant?
If naltrexone is tolerated and the patient is successful in reducing or stopping drinking, the recommended initial course of treatment is 3 months. At that time the patient and clinical staff should evaluate the need for further treatment on the basis of degree of improvement, degree of continued concerns about relapse and level of improvement in areas of functioning other than alcohol use.