What Is Naltrexone?

Naltrexone (Vivitrol®, Revia®) is an opioid receptor blocker that is prescribed to treat opiate dependence and addiction. It has also been successfully used in part to treat Alcohol Use Disorder (AUD). Opioid blockers bind to the opioid receptors in the brain and stop the “high” feeling. This means that effects of drugs like heroin, morphine, roxicodone, and many others, are not experienced. A drug user will not feel the physical effects of euphoria, comfort or well being associated with these drugs and it is anticipated that the user will not have the desire to take the opiate drug. Naltrexone interrupts the pathways in the brain that releases the “feel good” chemicals like endorphins when the drug is taken and has proven to be effective in reducing the frequency and severity of relapse.
Naltrexone is commonly prescribed in the oral form and must be taken daily to reduce the symptoms associated with opiate withdrawals and enhance recovery. However, the effectiveness of the drug is compromised by not adhering to the recommended dosage. To overcome this problem, the medical community had developed the Naltrexone Implant that can be implanted into the lower abdomen, inner thigh or arm or other inconspicuous regions of the body. It releases a controlled amount of Naltrexone into the bloodstream. In this form, the issues associated with skipping doses are removed and an opiate dependent person can work on overcoming his or her addiction.
Naltrexone is also available in a monthly injectable form as a prescription. The monthly injection eliminates the problem of daily dosing, but only lasts 30 days. This is, of course,a better option than daily oral tablets, but the expense and the short duration of action makes it less than ideal as a treatment option over Naltrexone Implant that gives you 90 days, instead.
Naltrexone is not a cure for addiction, but it can be a very powerful tool for those highly motivated individuals that need a simple method to reduce their temptation by providing for animmense blocker of the effects of opiates and alcohol. Naltrexone is not a narcotic. It will not cause mental or physical dependence. It will NOT prevent impairment while drinking alcohol.

Is Naltrexone FDA approved?

Yes. Naltrexone was approved by the FDA for the treatment of Opioid and Heroin abuse in 1984 and later for Alcoholism in 1995.

Are Pellets or Injectable Forms of Naltrexone Safe?

Certified compounding centers staffed by licensed pharmacists manufacture the pellet implant andthe injectable suspension form of Naltrexone while maintaining the highest quality. Naltrexone is relatively safe. Except in very rare incidences and in extremely sick patients, liver problems may occur, but in practice it has been exceedingly well tolerated by most patients. An insertion of Naltrexone pellets are done in an office setting under local anesthetic and usually takes 10 minutes. Patients are permitted to be unaccompanied and can drive home immediately after the procedure is completed. IMPORTANT:If Naltrexone therapy is started before the patient has sufficiently been off their narcotics or heroin, they can expect to experience severe opioid withdrawal symptoms within a few minutes*. Moreover, if a patient on Naltrexone therapy were to get in an accident and narcotic medication is needed the emergency physicians will need to provide for alternative forms of pain control that are not effected by Naltrexone, or be given higher amounts of strong painkillers to achieve the goal of pain control. Therefore, it is advisable to carry a wallet card or wear a Medic-Alert tag (bracelet, dog-tag, or necklace) to advise everyone that you are receiving Naltrexone maintenance therapy in the event that the patient cannot communicate this fact to his or her treating physicians and first emergency responders. *A short burst of a short-acting narcotic blocker (Naloxone Challenge Test) will be given immediately before any Naltrexone treatment to ensure that NO RESIDUAL NARCOTICS exist before receiving ANY form ofNaltrexone treatment (i.e. pellet, injection, or pill). This is for the patient’s comfort and safety! IMPORTANT:Naltrexone may increase the risk of overdose. If a person who is fitted with a Naltrexone implant or receives an intra-muscular injectionand uses an opiate drug or heroin will not feel the euphoria or pleasant experiences associated with the drug unless they take very large doses. This is because the Naltrexone blocks the opioid receptors that can only be overcome if a massive dose of an opiate drug is taken. Very high doses of opiate drugs are known to cause respiratory depression, which can lead to death.

What Are The Side Effects of Naltrexone?

As with any medication, some patients can experience side effects when taking Naltrexone. These are fairly minimal and include:
  • Nausea and Vomiting
  • Restlessness
  • Anxiety
  • Headache
  • Exhaustion

How Does Naltrexone Compare To Alternative Drugs of Methadone, Suboxone, and Subutex (MSS)?

Unlike opioid maintenance therapy drugs, Naltrexoneis NOT a narcotic and therefore does not produce a “high” effect. Naltrexone can be stopped at any time without any withdrawal risks or other ill effects. Although, the alternative drugs (MSS) should only be used for a short period of time to stabilize the patient, but instead most patients find themselves “hooked” or addicted to these prescription drugs and are just as difficult to quit as heroin or other painkillers. Naltrexone therapy does not carry these risks.

Is Naltrexone Pellet Therapy a Cure to Opioid or Heroin Addiction?

It is firmly believed that Naltrexone pellet therapy by itself is not a cure.However, a highly motivated person with a good family and social support structure can succeed when they know it is possible to eliminate the daily cravings and temptation duringNaltrexone therapy. Knowing there is no reward of getting“high”, the recovering addictcan focus and put effort backinto building vital life skills and strengthen theirsurroundings in preparation for lifelong sobriety.

Can Naltrexone Be Used To Treat Alcoholism?

Yes. However, the ultimate goal of recovery from alcoholism is total abstinence and learning how to existwithout it.There are a number of other medicationsused in combination that can assist in achieving and maintaining abstinence. Naltrexone is probably the most powerful of these medicines. Naltrexone is a drug that attaches and blocks the opiate receptors in the brain. Part of the pleasurable effect from drinking alcohol happens through these opiate receptors when they are activated from a flood of alcohol producing the release of endorphins.An inordinate amount of endorphins is the primary cause of why people enjoy drinking, but unfortunately for alcoholics their tendency to drink becomes excessive. When these receptors are blocked, there are fewer cravings for alcohol and less pleasure achieved when drinking. It becomes much easier to stay abstinent and continue with a successful recovery program.

What Is A Naltrexone Implant?

A Naltrexone Implant is a small pellet that is inserted into the lower abdominal wall or other inconspicuous area of the body under local anesthetic. The implant is effective for 3 monthsand releases a controlled amount of Naltrexone into the body. The implant works by blocking the effects of opiate drugs. It does this by binding to opiate receptors in the body which prevents opiate drugs like heroin or oxycodone from causing a person to experience the usual “high”. In blocking the effectiveness of the drug, Naltrexone helps to break the cycle of drug use.

Can The Oral Form of Naltrexone Be Taken Alone?

Yes. Naltrexone in the oral or injectable form does work, but there are distinct advantages to receiving a Naltrexone Implant. The implant releases a slow, steady dose of Naltrexone into the body resulting in consistent therapeutic drug levels over an extended period of time. This long term, consistent coverage is more effective in suppressing cravings, as there are significantly less fluctuations of the drug levels in the body. More importantly, having the implant removes the critical issue of compliance. Individuals do not need to decide or remember everyday whether or not they want to be sober. Oversleeping, forgetting, or skipping a dose can leave one vulnerable to the irresistible cravings for drugs and alcohol.

How Long Should I Continue Naltrexone Therapy?

The course of Naltrexone therapy should continue for at least 12 months. Ongoing research and clinical studies show that it will take up to a year or more for our brains to fully recover from addiction to opiates and alcohol. It may take longer to develop fundamental coping skills and healthy life-style changes to stay clean and happy.

When Is Naltrexone Therapy Not Suitable?

Naltrexone therapy may not be recommended in individuals with acute hepatitis or liver failure. Pregnant or breast-feeding mothers should consult with their physician before beginning Naltrexone therapy. Naltrexone is not suitable for people who are actively taking opiates within the period leading up to their treatment – for opiates or heroin, 7 days before, and 10-14 days before for Suboxone, Subutex and Methadone.

What Happens When Opiates or Heroin Are Currently Being Used?

It is imperative to be free from opiates or heroin for a minimum of one week before receiving a Naltrexone pellet. Those on Methadone, Suboxone (buprenorphine and naloxone) or Subutex (buprenorphine) should beoff their prescription for at least 10-14 days since these drugs take longer to clear from the body. Even if no opioids have been taken for the recommended time, there may be some mild to moderate withdrawals due to the chronic imbalance in the essential brain neurotransmitters.

Are Follow Up Appointments Necessary?

On an ongoing basis, it is important to receive the next pellet before the effects wear off to prevent relapse. Patients are advised to schedule their next pellet or injection, accordingly. Although the pellet lasts around 3 months,the duration of effectiveness varies with each patient.

Getting Started

After contacting our office, an approval for an initial consultation visit will be determined. The initial consultation fee is $250. This includes a full review of patient history, an intake screening exam and a completion of a consent form. Prior to the initial visit, all patients are required to provide a recent panel of blood work consisting ofComplete Blood Count (CBC) and Metabolic Panel consisting of electrolytes, liver function tests, and a number of other crucial items. If recent blood workis not available, we will fax an order formto the patient’s laboratory facility of choice.Once determined a good candidate, an order for the selected Naltrexone treatment option (pellet or injection) will be placed with the compounding pharmacy.Typically,an implant or injection visit is made one week after the initial exam. For out-of-state patients, a preliminary phone consultation and intense questionnaire session will be conducted in lieu of a face-to-face encounter. If any concerns are raised during this time we may request a medical clearance from your physician. For the most part, unless you’re severely ill, have serious medical condition, haven’t discontinued opioids or heroin in the required time frame, and finally, have major organ disease, our clients will likely be well enough to receive Naltrexone therapy. Once a client of our clinic, subsequent visitswill be waived. You will only be responsible for your cost of travel and accommodations, repeat laboratory tests, and, of course, for the Naltrexone therapy of your choice.

Contact Us Today to Get Started

IMPORTANT: Many individual patients receiving Naltrexone therapy may feel that they are “cured” after a few months of therapy due to the effectiveness of the implant and injection. Naltrexone is veryefficientwhen giving some time to work on their mental addiction without the relentless physical cravings. We advise all patients to seek counseling, particularly group therapy and most particularly active participation in 12-step recovery programs. Participation in a 12-step recovery program is the single most important form of follow-up care.