How Naltrexone Tablets Help Break the Cycle of Opioid Addiction

The OAD Clinic
Aug 9
7 min read

In simple words, naltrexone tablets block the effects of opioids in the brain. When taken consistently, naltrexone tablets become persistent in preventing the feelings of relaxation, joy and wellbeing that opioids normally produce which are highly addictive. This helps individuals stay focused on recovery and avoid relapse.

This post outlines naltrexone and its use to tackle opioid addiction.

What Is Naltrexone?

Naltrexone is a non-addictive, FDA-approved medication used in the treatment of opioid addiction. It is used as medication-assisted treatment to achieve long-term stability.

Overview of the Medication

Naltrexone is available as an implant, injection and as a tablet. Many people confuse naltrexone with naloxone injections. Naloxone injections have a very short half life (no more than an hour or so) and are used to block the effects of heroin overdose. Therefore, a naloxone injection is not suitable as opioid substitute treatment to achieve long-term stability.

On the other hand, naltrexone injections are effective and last one month. Unfortunately, naltrexone injections are not available in the UK and importation costs are very high. But what about naltrexone implants? Due to safety and efficacy concerns, the use of naltrexone implants is highly regulated and only permitted in specific circumstances, such as in a clinical research environment.

Why choose naltrexone over methadone or buprenorphine? Naltrexone has particular attributes in terms of its dependency and its efficacy.

Efficacy: as mentioned, naltrexone is effective at preventing relapse by blocking opioid receptors, which means opioids taken while on naltrexone will have little to no effect. However, its success heavily depends on adherence to treatment, to keep the blocking effect consistently present. I contrast, methadone and buprenorphine do not block the effects of opioids entirely. These medications only reduce withdrawal symptoms and cravings. Therefore, buprenorphine and methadone may be more effective for patients with severe addiction.
Dependency: while methadone and buprenorphine both provide very effective treatment for opioid addiction, they are opioid-based medications and as such there are side effects when stopping these medications. Even though they are safer alternatives to illicit opioid use, such treatments need close medical monitoring, especially while titrating and stopping treatment. Naltrexone does not cause physical dependence and there are no withdrawal symptoms when stopping it.

How It Works in the Body

Naltrexone is a mu, kappa- and delta-opioid receptor antagonist. In plain English, this means that a naltrexone tablet binds to the opioid receptors without activating them. As such, naltrexone tablets prevents opioids like heroin, morphine, and oxycodone from binding to these receptors Without opioid binding, opioids do not cause any of the addictive side effects in the body.

Long-term benefits of naltrexone treatment: by blocking these receptors over time, naltrexone tablets can help reduce cravings. The brain begins to adjust to not receiving the rewarding effects of opioids, which supports recovery and helps prevent relapse with a reduced desire and physiological need to take opioids.

The Role of Naltrexone in Treating Opioid Addiction

Naltrexone can play a critical role in comprehensive treatment for opioid addiction by helping to tackle the physical aspect of dependence to allow the patient to focus on the psychological cycle of dependence. Unlike opioid-based treatments, it blocks the effects of opioids and works best when integrated into a full recovery plan that includes behavioural therapy and medical supervision.

Breaking the Reward Cycle

One of the key ways naltrexone supports recovery is by completely removing the positive reinforcement associated with opioid use. By blocking opioid receptors in the brain, it eliminates the desire and need to take opioids. This helps make relapse less rewarding and less likely because the learned behaviour is not reinforced anymore and is weakened with prolonged treatment.

Supporting Long-Term Abstinence

Over time, naltrexone tables as treatment for opioid addiction act as a safety net for individuals who are committed to staying off opioids, allowing them to focus on long-term recovery goals without the distraction of cravings or the temptation to use again.

Comparison with Other Medications

Compared to other treatments like methadone and buprenorphine, naltrexone differs significantly in its:

Mechanism: naltrexone blocks opioid receptors, while methadone and buprenorphine activate them at lower levels to reduce withdrawal. In plain English: if opioids are consumed while on naltrexone tablets, none of the effects of opioids will be felt. However, if opioids are consumed while on buprenorphine or methadone treatment, some of the effects of opioids will be felt.
Risk: naltrexone has no abuse potential and no withdrawal symptoms when stopped. Methadone and buprenorphine require gradual tapering due to their mild mechanisms of action. The risk with naltrexone is that relapse may lead to overdosing because naltrexone denies the user from feeling any side effects even if high opioid doses are taken. Many people then take even higher doses once they are off naltrexone, leading to overdose. Therefore, when seeking treatment for opioid addiction, the use of naltrexone for the detoxing stage is a riskier option.
Benefits: naltrexone is ideal for patients who want a non-opioid option and have already completed detox.

Who Can Benefit from Naltrexone Treatment?

Naltrexone is most effective for individuals who are fully detoxified, motivated to stay abstinent, and engaged in a structured recovery programme to address mental triggers to addiction. It can be particularly beneficial for those who prefer a non-opioid-based treatment for opioid addiction.

Ideal Candidates

The ideal candidates for naltrexone treatment are:

Individuals who have completed opioid detoxification
Patients who are committed to abstinence
Those who have a strong support system or are participating in counselling or therapy

Considerations and Medical Assessment

Before starting naltrexone tablets, a comprehensive medical evaluation is essential. This may include liver function tests, overall health status, whether any other medications are being taken, and in some cases requesting that the patient is opioid-free for at least 7 to 10 days to avoid withdrawal during the stable phase of treatment for opioid addiction where naltrexone tablets are prescribed. A healthcare provider will assess risks and determine the appropriateness of prescribing naltrexone tablets at the patient's current recovery stage.

Not Suitable for Everyone

Naltrexone may not be appropriate for:

Patients who are still actively using opioids
Individuals with acute liver disease
Pregnant or breastfeeding women
Patients unable to commit to treatment by not taking naltrexone tablets on an ongoing basis as indicated by the healthcare provider

What to Expect During Naltrexone Treatment

During treatment with naltrexone tablets, patients can expect:

Regular dosing, usually once daily or a few times a week
Periodic follow-ups
Monitoring of liver function and overall health
If a psychological dependence is identified, support through therapy and group counselling may be necessary

Success depends on adherence, motivation, and the presence of a strong recovery support network.

Dosage and Administration

Naltrexone tablets are typically prescribed as 50 mg once daily, though alternative dosing schedules may be used (for instance, 100 mg every other day). The duration of treatment varies but is often recommended for several months to a year, depending on individual progress.

Side Effects and Safety

Common side effects of Naltrexone include:

Nausea
Headache
Dizziness
Fatigue
Sleep disturbances

Serious but rare side effects can include liver function problems and allergic reactions Regular reviews with you clinician are recommended at the start of treatment with naltrexone tablets, but patients should be urged to report any adverse symptoms to their clinician.

Importance of Adherence

Sticking to the naltrexone treatment plan is critical. Missing doses can weaken the medication’s effectiveness and increase the risk of relapse. Patients are encouraged to use reminders, attend regular follow-ups, and stay engaged and motivated.

Integrating Naltrexone with a Comprehensive Recovery Plan

When looking for treatment for opioid addiction, there are some cases where naltrexone is most effective when combined with a comprehensive recovery strategy. This includes:

Individual or group therapy
Counselling to address underlying emotional issues
Support groups like Narcotics Anonymous (NA)
Family involvement and lifestyle changes

This holistic approach helps address not just the physical aspect of addiction, but also the emotional and psychological triggers in human behaviour which cause the addiction and relapse.

Final Thoughts

Treatment for opioid addiction and recovery are both challenging journeys. Recovery is absolutely possible with the right support, commitment, and treatment plan.

Naltrexone offers a powerful, non-addictive option for those who are already breaking the cycle of opioid dependence and are abstinent. When used responsibly and combined with counselling and a strong support system, naltrexone tablets can significantly reduce cravings, prevent relapse, and support long-term abstinence.

Every individual’s recovery path is unique, and with proper medical guidance and a specific, personalised plan, naltrexone can be a key part of building a healthier, drug-free future.

Frequently Asked Questions (FAQ)

Is naltrexone addictive?

No, naltrexone is not addictive. It does not produce a high, cause physical dependence, or lead to withdrawal symptoms when stopped. This makes it a safe option for those looking for a non-opioid-based treatment for opioid addiction.

How effective is naltrexone in treating opioid addiction?

Naltrexone can be very effective when used consistently and as part of a comprehensive treatment plan. It blocks the effects of opioids, reduces cravings, and helps prevent relapse, especially in individuals who are motivated and committed to recovery.

Do I need to detox before starting naltrexone?

Yes, you must be fully detoxed from opioids (typically for 7 to 10 days) before starting naltrexone. Starting too soon can cause sudden and severe withdrawal symptoms, so it's important to follow your doctor’s guidance.

How long should I take naltrexone for opioid addiction?

It depends. The duration can vary, but many treatment plans recommend taking naltrexone for several months to a year. Long-term use helps reinforce abstinence and provides ongoing protection against relapse.

Can naltrexone be used with other therapies?

Absolutely. Naltrexone, like methadone and buprenorphine. works best when combined with counselling, therapy, and support groups. No matter what treatment for opioid addiction you decide to go for, a well-rounded treatment plan addresses both the physical and psychological aspects of addiction.

Is naltrexone better than methadone or buprenorphine?

Again, it depends on the individual. Naltrexone is ideal for people who have completed detox and want a non-opioid option. Methadone and buprenorphine, on the other hand, may be more suitable for those who need help managing withdrawal symptoms and cravings during early stages of recovery. The best treatment varies depending on the person and should be decided with a healthcare provider.