Naltrexone is frequently used in the treatment for alcohol use disorder, but its role in the recovery process is often misunderstood. While it has demonstrated effectiveness in certain phases of treatment, its timing and application are critical to both safety and success.
This article explores how this medication works, its relationship to alcohol cravings versus withdrawal, and when it may be introduced as part of a broader recovery plan.
What Is Naltrexone and How Does It Help
Naltrexone is an opioid antagonist approved for managing alcohol use disorder. It works by blocking opioid receptors in the brain, thus reducing alcohol-induced euphoria and cravings. Naltrexone is most effective when paired with counseling and support. It is available as a daily oral tablet, for example, ReVia or Depade, or a monthly injection like Vivitrol.
Studies confirm that it significantly lowers the number of drinking days, delays relapse, and supports longer periods of abstinence.
Understanding Withdrawal vs Cravings
It’s essential to distinguish between acute alcohol withdrawal and ongoing cravings. Withdrawal begins when a chronic drinker reduces or stops alcohol intake. Symptoms can range from tremors and insomnia to life-threatening complications like seizures and delirium tremens. These symptoms typically peak within 24 to 72 hours after cessation and can last up to a week.
Cravings, on the other hand, are psychological urges triggered by emotional cues or environmental reminders. They may persist months after physical withdrawal ends and are a major risk factor for relapse.
Why Naltrexone Should Not Be Used During Withdrawal
Using medications like Revia before withdrawal subsides can worsen symptoms. Since it blocks opioid receptors integral to alcohol’s effects, starting it too early may intensify tremors, anxiety, or other withdrawal signs. Medical guidelines insist on a full detox, not active withdrawal, before initiating naltrexone therapy.
Evidence supports this protocol: programs recommend waiting 7–10 days after the last drink before using this medicine to reduce adverse reactions and ensure it’s effective at targeting cravings rather than withdrawal.
When to Start Naltrexone After Detox
Naltrexone is generally introduced after the acute withdrawal phase has fully resolved, often following a period of at least one week without alcohol. At this stage, it may be prescribed in either oral or extended-release injectable form, depending on individual needs and treatment goals. Healthcare providers typically begin with a lower oral dose to assess tolerance before moving to a standard daily dose or administering a monthly injection.
Our drug and alcohol detox in Utah provides medically supervised detox to ensure withdrawal symptoms are managed safely and effectively. Once the process is complete, our team works closely with each individual to determine the right time and method for starting medications, forming part of a personalized recovery plan.
Long-Term Effectiveness of Naltrexone
When used as part of a comprehensive treatment plan, naltrexone can support efforts to reduce alcohol use over time. It may be used alongside counseling or structured therapy to help individuals manage cravings and maintain progress in recovery.
In some treatment approaches, this drug is taken before anticipated drinking episodes to help reduce the amount consumed. How and when it is used varies by individual, and decisions are made based on clinical assessment and ongoing response to treatment.
Safety Considerations and Side Effects
- Naltrexone is generally safe when used as prescribed.
- Mild side effects may include Nausea, Insomnia, Anxiety and Headache
- Liver function monitoring is recommended, especially for individuals with existing liver conditions.
- This medication carries a rare risk of liver toxicity.
- Patients must avoid opioid medications while taking naltrexone.
What Medications Are Used for Withdrawal Management
For acute withdrawal, benzodiazepines remain the gold-standard treatment. They safely reduce anxiety, tremors, and seizure risk. Additional support may include thiamine (to prevent Wernicke’s encephalopathy) and symptom-specific medications for nausea or insomnia. Unlike naltrexone, which blocks alcohol’s euphoric effects, these treatments stabilize the body during physical detox.
Final Thoughts from Guidance Detox
Understanding the distinction between withdrawal management and craving control is essential when considering naltrexone. Used at the appropriate time, after detox, it can significantly aid sobriety, but it should never replace proper withdrawal care.
At Guidance Detox & Rehab, we provide premier inpatient rehab programs in Utah, including medically supervised detox and evidence-based support for alcohol use disorder. Our programs combine behavioral therapy, medication-assisted treatment, family involvement, and relapse prevention planning. Early intervention and correct medication management are pivotal in achieving lasting recovery and mental health stabilization.
