HomeFAQ About Naltrexone | Alcohol & Opioid Recovery Treatment

FAQ ABOUT NALTREXONE THERAPY (NALTREXONE PELLET/HEROIN BLOCKER)

If you or a loved one are considering treatment for alcohol, cocaine, or heroin dependence, you may have heard of Naltrexone. This medically approved treatment is used worldwide to help individuals regain control over substance use and support long-term recovery. This page of FAQ about Naltrexone provides clear, reliable answers to common questions, including how it works, who it is suitable for, possible side effects, and what to expect during treatment.

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Why Is Naltrexone Therapy Important?

1.Reduces Cravings and Helps Prevent Relapse
Naltrexone can help you manage cravings by blocking the pleasurable effects of alcohol and opioids, making it easier to stay committed to your recovery.

2.Safe and Non-Addictive
Unlike some other treatments, such as methadone or buprenorphine, naltrexone is not addictive, does not cause withdrawal symptoms if stopped, and will not give you a ‘high’.

3.Improves Chances of Long-Term Recovery
When combined with counselling or behavioural therapy, Naltrexone significantly increases the likelihood of achieving lasting recovery.

4.Flexible Ways to Take It
Naltrexone comes in oral tablets, monthly injections, or long-acting implants, so treatment can be tailored to what suits you best.

5.Supports Your Brain and Emotional Recovery
By reducing cravings and blocking the effects of substances, Naltrexone gives your brain time to heal, helping both your emotions and thinking to recover more effectively.

Our patient from the UK shares her experience with Naltrexone for alcoholism:

Naltrexone tablet usually works for only 24 to 48 hours, and in real life, many people either forget to take their medication or decide not to. Unfortunately, this can sometimes lead to a relapse, with some returning to heroin use quite quickly.

We know that patients are more successful when they have support—whether from close family members or, in some cases, through legal supervision such as probation or parole.

For this reason, we often recommend the Naltrexone implant. It provides a steady, long-lasting release of medication, so you don’t need to take a daily dose, which greatly reduces the risk of missing treatment.

We also advise continuing Naltrexone therapy for at least 12 months. This allows your brain’s reward system time to heal from the effects of substance use and gives you a valuable window to make meaningful, lasting changes to your lifestyle and behaviour, supporting a stable, long-term recovery.

Substitution Therapy:

-Opiate substitution therapy involves the use of prescribed, legal opioids such as methadone (Heptanon), buprenorphine (Subutex, Suboxone), morphine sulphate (Substitol, Compensan), and occasionally medically prescribed heroin.
-These medications are taken under medical supervision as part of a structured treatment plan for heroin addiction. Patients continue using legal opioids while working towards gradually reducing their daily doses.
-The aim of this approach is to help patients maintain employment and social stability, even while still using prescribed opioids. However, opiate tolerance remains, which can mean some patients add heroin, sedatives, or other substances. This can complicate the addiction and make recovery more challenging.
-It is often more difficult to stop taking methadone than to quit heroin entirely. It is important to understand that opiate substitution therapy is not a cure for addiction; rather, it is a harm reduction strategy.
-The programme’s primary goal is to reduce the risks and harms associated with illegal drug use, both for the individual and for society as a whole.

Difference Between Methadone (or Other Opioid Substitution Therapy) and Naltrexone Maintenance Therapy

Methadone and other opioid substitution therapies work by using medications that activate the same opioid receptors in your brain, such as methadone or buprenorphine. These medications help reduce withdrawal symptoms and cravings by providing a controlled opioid effect. However, it’s important to understand that you remain dependent on these substitute opioids and maintain opioid tolerance. The main aim of substitution therapy is harm reduction and stabilisation, helping you lead a more regular life while gradually reducing your opioid use. Stopping these medications can be prolonged and challenging, and some patients may continue to use illicit drugs alongside their prescription.

Naltrexone therapy works in a very different way. Naltrexone is an opioid antagonist, which means it blocks opioid receptors and prevents any opioid from producing its usual effects. This helps reduce cravings and lowers the risk of relapse, because using opioids will no longer give a “high.” Unlike substitution therapy, Naltrexone does not cause dependence, but you must be fully detoxified before starting treatment. Naltrexone can be taken as daily tablets, monthly injections, or implants, and it works best when combined with counselling or behavioural therapy.

In short, substitution therapy maintains opioid dependence but aims to reduce harm and stabilise your life, whereas Naltrexone therapy supports complete abstinence by blocking opioid effects and helping you avoid relapse. Both treatments have their place, and the right choice depends on your individual circumstances and guidance from a medical professional.

What Are the Side Effects of Naltrexone?

Like any medication, Naltrexone can cause some unwanted side effects. In our experience, around 3% of patients report feeling tired, weak, or dizzy. Some may also experience mild abdominal discomfort or low mood. The good news is that these symptoms usually last less than a day.

For this reason, we recommend resting on the first day of Naltrexone treatment. If any side effects persist or cause concern, please contact your GP without delay.

Below, you can read about the effectiveness of the Naltrexone implant in treating heroin addiction, as shared by a patient from the UK:

FAQ About Naltrexone: How Does It Prevent Relapse?

Naltrexone, often called the “heroin blocker,” is an opioid antagonist that blocks the effects of heroin and other opioids such as methadone or Suboxone. It works by attaching to opioid receptors in the brain, preventing these drugs from binding and producing their effects. If opioids are taken while on Naltrexone, they will have no impact, making their use ineffective and discouraging relapse.

This action helps to prevent relapse by reducing cravings and giving you greater confidence during recovery—much more than with unprotected abstinence alone.

When Can Naltrexone Treatment Begin?

Naltrexone treatment should only start once tests confirm that your body is completely free of opioids. This ensures there will be no withdrawal reactions when using the Naltrexone implant or injection, allowing treatment to proceed smoothly.

Typically, Naltrexone maintenance can begin 7 days after the last heroin use, or 20 days after the last methadone dose.

What unwanted reactions to Naltrexone can be expected? Can they be avoided?

If a person has not undergone proper opioid detoxification, including necessary drug testing and thorough cleansing of the body, they may experience uncomfortable withdrawal symptoms.

Are there any potential risks or side effects associated with the Naltrexone implant?

There is a risk, in fewer than 8% of cases, of a foreign body reaction associated with the Naltrexone implant. This may include irritation, inflammation with swelling and redness, wound opening, implant rejection, or, in some cases, infection at the implant site. Fortunately, these reactions are usually mild and can be effectively managed with proper assessment and prompt antihistamine and anti-inflammatory treatment.

By following the recommended recovery regimen and all other advice provided, and by ensuring that wound care and dressing changes are carried out by a skilled and experienced nurse, the risk of complications can be significantly reduced.

Is naltrexone implantation legal?

Yes, it is—though not in all countries or in every situation. In some places, it is permitted under specific conditions.

United Kingdom: Legal but unlicensed; available on a named patient basis with a special prescription.
Russia: Legal, approved, and used as standard clinical practice for addiction treatment.
Serbia: Legal but not registered; requires a special prescription from a psychiatrist (addiction specialist) and is performed by a trained surgeon.

Are there any risks and side effects after the Naltrexone injection administration? How can they be avoided?

Naltrexone injection (also known as Vivitrol) may, in extremely rare cases, cause an allergic reaction. When this occurs, prompt administration of anti-allergy treatment can quickly neutralise the reaction and prevent further complications.

To minimise the risk of infection at the injection site, it is essential that the intramuscular opioid blocker is administered by a qualified healthcare professional, ideally a trained nurse using strict sterile technique.

With proper care, both allergic and infectious complications are highly unlikely.

FAQ about Naltrexone implants

What Happens if Someone Takes Opiates During Naltrexone Maintenance?

The body's reaction to opiate use during Naltrexone maintenance depends on several factors, including:

-The type and dosage of the opiate drug
-The individual's receptor sensitivity at that particular stage of abstinence
-The strength and current blood level of Naltrexone

In most cases, the opiates will have little or no effect, as Naltrexone blocks the receptors in the brain that opiates normally bind to. Some individuals may experience only mild or blunted effects, which are typically unsatisfying.

However, in a worst-case scenario, someone might attempt to override the blockade by taking a very high dose of opiates. This can lead to a dangerous or even fatal overdose, as the respiratory system may become suppressed without warning signs of euphoria or sedation.

Can the Naltrexone blocker be overridden?

Among drug users and dealers, there are often stories and claims about methods to override the Naltrexone implant. Some study chemistry and pharmacology, while others experiment or even organise competitions to see who can most quickly bypass the implant’s effects. Survivors of such attempts sometimes boast online about their “success” in defeating the implant.

While it is technically possible for a determined individual to sabotage any treatment and end their abstinence, such actions carry a very high risk to life. Attempts to override or neutralise Naltrexone’s effects are dangerous and can lead to severe health consequences or fatal overdose!

These individuals often portray themselves as either heroes or victims afterwards, raising the question: why did they seek a Naltrexone implant in the first place?

Naltrexone implants are specifically designed to protect opioid receptors from occasional or accidental drug intake, making the effects of heroin or similar drugs ineffective and preventing relapse. They are not intended to withstand systematic, repeated, and persistent attempts to override, melt, or neutralise the blockade.

How can one avoid risky attempts to bypass the implant and prevent serious complications, including the risk of death?

Patients should be fully informed about Naltrexone maintenance therapy. It is important not to perpetuate the myth that Naltrexone is a perfect or final solution — the idea that you can simply “take an implant and forget about heroin” is not true. There is no definitive cure for drug addiction, and no one has yet been awarded a Nobel Prize for eradicating heroin dependence.

While Naltrexone implants represent one of the most effective methods currently available among many treatment options, there are no guarantees. Research and development in addiction treatment continue to evolve, and Naltrexone remains a valuable tool within a broader recovery process.

When is it appropriate to say goodbye to a Naltrexone implant and have it removed?

A Naltrexone implant is intended to prevent relapse in cases of accidental opiate use. It is not designed to protect against deliberate attempts to override the opiate receptor blockade through repeated opiate intake. When a patient knowingly takes opiates despite an active Naltrexone blockade—putting their life at serious risk—and eventually overrides the implant’s protection, it indicates that they have effectively withdrawn from the Naltrexone maintenance programme.

To avoid potentially fatal consequences, it is crucial that patients communicate openly with their Naltrexone specialist about their intentions and arrange for the safe removal of the implant.

What should I do if I’m not confident my Naltrexone blocker is working? How can I test its effectiveness?

If you have doubts about the effectiveness of your Naltrexone blocker or suspect that the implant is not releasing Naltrexone into your system, you can always have blood test done and verify Naltrexone levels in your blood.

If necessary, additional Naltrexone protection can be provided to give you peace of mind.

Are there any signs that may indicate a patient is considering ending their abstinence and returning to drug use?

Yes, certainly. A patient who is considering ending their abstinence often begins to ignore medical advice and the conditions of their Naltrexone treatment. For example, they might "forget" to take follow-up medications, neglect sterile wound care during dressing changes, consume alcohol, or apply physical pressure to the implant site.

Additionally, if they stop submitting regular reports about their Naltrexone maintenance, it often signals a decline in motivation and commitment to abstinence, which can soon lead to cravings and a potential relapse.

Do you have more FAQ about Naltrexone? Feel free to mail us.

Can Naltrexone Aid in the Treatment of Alcohol Dependence?

Yes, Naltrexone can reduce the alcohol pleasure and curb cravings, making it a valuable aid in the treatment of alcohol dependence. It has been successfully used in many countries since the 1970s, giving people a good opportunity to reduce or even stop alcohol consumption.The Depot Naltrexone formulation, known as VIVITROL, is even approved by the FDA specifically for the treatment of alcoholism.

However, it is important to note that Naltrexone acts through opioid receptors and does not directly block the effects of alcohol, and it may not be effective for everyone. Some patients have reported that Naltrexone did not significantly affect their alcoholism. Others found it helpful initially, but its effectiveness diminished after a few months. This suggests that the body may adapt to the effects of Naltrexone if alcohol use continues regularly.

What is the risk of overdose after completing Naltrexone maintenance?

Studies show that some patients have died following periods of abstinence from drugs. This is largely due to a loss of tolerance after abstaining. While Naltrexone is highly effective at helping addicts stay off opioids, once its effects wear off, patients’ tolerance to opioids is significantly reduced.

As a result, it is very easy for them to accidentally take a fatal overdose of heroin or other opiates. It is crucial that patients fully understand this risk and exercise extreme caution if they relapse. There is also a danger of overdose if someone attempts to override their Naltrexone therapy.

What should I do if cravings appear during Naltrexone therapy?

If cravings arise — often triggered by contact with other users, dealers, or emotionally charged situations — they are typically accompanied by feelings of restlessness, emotional tension, and a strong urge to use drugs.

In many cases, the most effective solution is to reinforce the Naltrexone blockade. This can be done by administering an additional Naltrexone implant or a Depot Naltrexone injection. Strengthening the blockade is often enough to help the individual calm down, regain control, and re-engage with the recovery process.

In some instances, a more structured anti-craving programme may be necessary. This may involve counselling, medication, and behavioural therapy to address the emotional and psychological aspects of craving.

Prompt action is crucial — do not ignore the early signs. Seek professional support immediately to prevent relapse.

How long should a patient be on Naltrexone therapy?

We firmly believe that former drug users or alcohol users should remain on Naltrexone therapy for a minimum of twelve months.
This greatly reduces the risk of relapse into narcotic use and gives the brain’s reward system vital time to recover from the effects of addiction. The twelve-month period also offers a valuable opportunity to establish new habits, rebuild emotional resilience, and make meaningful lifestyle changes that support long-term recovery.

Does the Naltrexone implant remain under the skin after its opiate-blocking effect has worn off?

Yes, the Naltrexone implant often remains under the skin even after its active blocking effect has ended. In many cases, it takes several weeks for the remaining pellet material to fully dissolve.

Occasionally, the implant may appear to “disappear” earlier than expected. This can be influenced by a number of factors, including:

Local inflammation at the implant site
Disruption in the formation of the fibrous capsule around the implant
Accelerated metabolism of the biodegradable polymer by the patient’s enzyme systems
Fragmentation of the pellet into smaller pieces
Increased tissue friction due to strong muscle contractions or physical activity

These variables can shorten or prolong the time the implant remains physically present in the body. If you have concerns about your implant’s duration or effectiveness, please consult your doctor or contact us directly.

FAQ about Naltrexone

Do you have more FAQ about Naltrexone implants?

Some patients attempt to interfere with the implant—some have even admitted to trying to heat it with a hairdryer or a hot water bottle. Others have reported trying to crush the implant within their body. A few, more discreetly, have simply asked a surgeon to remove it.

None of these individuals fully understood the consequences of their actions. However, if a patient decides to take responsibility and correct their course, we are here to help them return to Naltrexone maintenance therapy.

What Recommendations Must Be Followed After Naltrexone Chip Insertion?

Visit a medical facility regularly for wound dressing changes and surgical check-ups.
Keep your dressing clean and dry. Do not soak in a bath or tub. If you shower, the wound must be covered with plastic to keep it dry.
Avoid intense physical activity and any sports involving the muscles around the implant. Do not lift or carry more than 10 kilograms, and avoid alcohol for at least four weeks following the implantation.
Ensure your stitches are removed on time, usually on the 7th day after the procedure.
Visit a doctor and contact us immediately at ask@refindyourway.com if there is any doubt or concern regarding possible complications, the Naltrexone process, or any other issues related to your treatment.

Feel free to read more FAQ about Naltrexone implants.

Does the Naltrexone Implant Work for the Full Intended Duration?

Neither the implant nor the human body functions like a timer. For some individuals, the implant may remain active for a slightly shorter period, while for others it may last longer. At our Naltrexone implant clinic, we use 2,500 mg depot Naltrexone pellets as part of our standard six-month maintenance programme. These have been shown to remain active for up to 7.5 months in some patients. For the 12-month programme, we use 5,000 mg pellets, which may remain effective for up to 13 months in certain cases.However, it is important to note that with repeated implantation (for example, a second, third, or fourth implant), the liver may adapt by metabolising Naltrexone more quickly. As a result, blood levels of the medication can gradually decrease over time.For this reason, it is not possible to guarantee the exact duration of effectiveness in every case. Regular follow-up and monitoring are strongly recommended to ensure ongoing therapeutic benefit.

Does Naltrexone Affect the Liver? FAQ About Naltrexone

Several studies have shown that the incidence of ALT (alanine aminotransferase) elevation during Naltrexone therapy is similar to that observed with placebo. In most cases, increases in liver enzymes during treatment are mild and self-limiting, often resolving on their own even while continuing the medication.

However, as with any medication processed by the liver, regular liver function monitoring may be recommended, especially for individuals with a history of liver disease or heavy alcohol use.

Why Might My Implant Not Be Working?

There could be several possible reasons:

Your body has not yet developed a proper fibrinous capsule to fully enclose the implant. Without sufficient protection, the implant may degrade too quickly and lose effectiveness.
Your body has formed a capsule around the implant that is excessively hard or thick, and continues to produce internal scar tissue. As a result, the medication cannot be released into your system in an adequate dosage.
You may have a naturally fast metabolism, causing the Naltrexone to break down and be excreted more rapidly than usual.
The implant globule may have been damaged or ruptured beneath the skin, leading to faster dissolution and reduced efficacy.
An inflammatory reaction may have occurred at the implant site. This can interfere with proper capsule formation, or the swelling may prevent the Naltrexone from entering your bloodstream effectively.
Your implant may still be active and successfully suppressing cravings for drugs or alcohol. However, external triggers such as boredom or exposure to provocative situations may have led you to voluntarily break your abstinence.

Is Naltrexone Registered and Recommended for Medical Use?

Yes. Naltrexone is an officially registered medication worldwide and is recommended for the treatment of alcohol and drug dependence. The FDA has approved oral forms of Naltrexone, as well as an injectable formulation marketed under the brand name Vivitrol. However, depot Naltrexone pellets for subcutaneous implantation have been officially approved only in the Russian Federation. In other countries, doctors may prescribe them off-label, meaning the medicine is not formally registered for that specific use. When treatment involves an unregistered or off-label medicine, it places greater responsibility on the patient to make an informed decision and to follow all medical recommendations carefully. We strongly advise you to learn more about Naltrexone therapy on this website and to discuss your treatment options with qualified medical specialists.

Where are the Implant Patients from?

We welcome motivated patients from anywhere in the world. The most important thing is that they are well informed by this website and come of their own free will—not under pressure from family or friends.However, most of our patients come from the UK and Ireland. They often have prior positive experience with Naltrexone through several clinics in England. Now they seek modern implant treatment and share information about this method across the UK.

Generally, British patients tend to be well aware of both the benefits and risks of Naltrexone treatment, making them more responsible and motivated to maintain abstinence. Medical practitioners throughout the UK are mostly familiar with Naltrexone implants, as the first implant centre in London began offering blockers back in 1998.

Today, we provide modern, high-strength Naltrexone pellets for long-term sobriety support—lasting up to a year—to patients from England, Ireland, Scotland, Wales, and other English-speaking regions.

The FAQ about Naltrexone and the answers here reflect more than 17 years of our medical team’s experience in treating opioid, cocaine, and alcohol addiction with Naltrexone.