Naltrexone and Alcohol: What Happens If You Drink While on Naltrexone?

July 2, 2022

Table of Contents

Naltrexone is a medication that can help you avoid drinking. It can be part of a treatment plan that helps you develop a healthier relationship with alcohol use.

What Is Alcohol Use Disorder?

In 2019, more than 14.1 million adults and 414,000 adolescents in the U.S. had an alcohol use disorder (AUD).[1]

AUD is a medical condition in which a person engages in frequent or heavy drinking despite experiencing negative consequences. It is caused by brain changes that make it hard for the person to remain in control of their drinking. AUD exists on a spectrum from mild to severe.

The more symptoms you have, the more severe your AUD may be. 

Symptoms of AUD can include:[2]

  • Spending a lot of time using or recovering from alcohol
  • Drinking more than you meant to
  • Wanting to cut back on drinking, but not being able to
  • Craving alcohol or having trouble thinking about anything else
  • Experiencing problems at work, school, or home or having trouble keeping up with your responsibilities
  • Having problems with your relationships, family members or friends because of your drinking
  • Spending less time on the activities you used to enjoy
  • Engaging in risky behaviors while drinking
  • Having withdrawal symptoms while not drinking, including insomnia, restlessness, nausea, or a fast heart rate

There are several treatments available for people with AUD. Medication for Addiction Treatment (MAT) is a type of therapy in which medications are used to help reduce alcohol cravings or withdrawal symptoms. Behavioral therapy can also help change attitudes and behaviors surrounding alcohol use. Additionally, many people with AUD take part in support groups.[1]

Getting professional help is important for people with severe AUD. When someone is dependent on alcohol, they may experience life-threatening withdrawal symptoms once they try to stop drinking.[1]

Treating AUD with Naltrexone

Treating Alcohol Use Disorder with Naltrexone

Naltrexone is a medication commonly sold under the brand names Revia and Vivitrol. It is a type of MAT that is approved by the U.S. Food and Drug Administration (FDA) to treat AUD as well as opioid use disorder (OUD)

When you take naltrexone as part of an AUD treatment program, you may:[3]

  • Experience reduced cravings for alcohol
  • Drink lower amounts of alcohol
  • Have a greater chance of remaining alcohol-free
  • Relapse (start drinking again) less often

Naltrexone has the opposite effect as alcohol within the brain. Drinking leads to activation of opioid receptors — proteins found within nerve cells. This causes the release of the brain chemical dopamine, which activates a “reward pathway” in the brain. 

Dopamine makes you feel good and causes you to want to continue doing whatever behavior activated the pathway in the first place — in this case, drinking.[4]

Naltrexone, on the other hand, attaches to and blocks the opioid receptors. This prevents the brain from being flooded with dopamine, and changes the way your brain is wired to respond to motivation and rewards. 

Simply put, drinking won’t feel as good to you. You won’t notice any “reward” for drinking, so you’ll be less likely to want to continue to do it.[4]

How Is Naltrexone Used?

A prescription is required in order to use naltrexone. If you are taking naltrexone for AUD, you will typically take a pill once per day and use it for three to four months.[5] 

Make sure to follow your doctor’s directions for when and how to take naltrexone. Using this medication as recommended helps increase your chances of overcoming an AUD. 

You shouldn’t start using this medication if you are still dependent on alcohol. Usually, you will first taper off of alcohol with the help of a medical professional, and once that process is complete you can start taking naltrexone. This helps reduce your chances of experiencing naltrexone side effects.

Naltrexone is an option for people over the age of 18 without other major health conditions.[5] 

If you are pregnant, are breastfeeding, have liver or kidney problems, or have been diagnosed with a bleeding disorder, you should talk to your doctor about whether naltrexone may be a good option for you before beginning treatment.

Additionally, tell your doctor about any other medications you are taking, including over-the-counter drugs and supplements.

Naltrexone Side Effects

Although naltrexone can help people better control their drinking, it is also important to know that the medication can cause side effects such as:[6]

  • Nausea or vomiting
  • Stomach cramps
  • Diarrhea
  • Constipation
  • Headache
  • Dizziness
  • Watery eyes
  • Sleeping problems or tiredness 
  • Feelings of irritability or anxiety

Tell your doctor if you are experiencing severe side effects while taking naltrexone, or if the side effects don’t go away.

Is Naltrexone Addictive?

No, you can’t become addicted to naltrexone. Although naltrexone attaches to opioid receptors in the brain, it is not an opioid drug. 

Unlike opioids, naltrexone doesn’t lead to dependence or cause withdrawal symptoms once you stop using it.[5]

Drinking While on Naltrexone

What Happens if You Drink on Naltrexone

Taking naltrexone makes drinking feel less enjoyable. You may find that you aren’t interested in drinking as much as you once were. The idea of having alcohol may feel unappealing. You may also notice that you have fewer cravings or spend less time thinking about alcohol.

Another type of medication, disulfiram, makes you feel extremely sick after drinking only a small amount. You may develop severe nausea, vomiting, headache, blurry vision, sweating, or breathing problems. However, naltrexone works in a different way than disulfiram.[8]

The combination of naltrexone and alcohol won’t cause any severe illness. It is important to know that naltrexone may make you feel less drunk, but you will still be impaired.[7] If you take naltrexone and then drink some alcohol, you will have decreased coordination and judgment abilities. 

Make sure to avoid driving or engaging in other risky behaviors, even if you don’t have that buzzed or drunk feeling.

Explore Opioid and Alcohol Use Disorder Treatment Options

With the help of medications, recovery from opioid or alcohol use disorders is possible, and with a high success rate. Call us today at (844) 943-2514 or find a time to speak with one of our team members to learn more about the recovery process.

Karen Vieira, PhD

Dr. Karen Vieira has a Ph.D. in Biomedical Sciences from the Department of Biochemistry and Molecular Biology at the University of Florida College of Medicine, a Master of Science in Management, and a Bachelor of Science in Molecular Biology.

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Citations

1. Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. Updated April 2021. Available from: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder 

2. Alcohol Use Disorder (AUD). MedlinePlus. Updated October 26, 2021. Available from: https://medlineplus.gov/alcoholusedisorderaud.html 

3. Streeton C, Whelan G. Naltrexone, a relapse prevention maintenance treatment of alcohol dependence: a meta-analysis of randomized controlled trials. Alcohol Alcohol. 2001;36(6):544-552. 

4. Sudakin D. Naltrexone: Not Just for Opioids Anymore. J Med Toxicol. 2016;12(1):71-75.

5. Naltrexone. Substance Abuse and Mental Health Services Administration. Updated November 4, 2021. Available from: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone 

6. Naltrexone. MedlinePlus. Updated December 16, 2021. Available from: https://medlineplus.gov/druginfo/meds/a685041.html 

7. 5.1: Naltrexone. Answers to Frequently Asked Medication Questions. National Institute on Alcohol Abuse and Alcoholism. Available from: https://pubs.niaaa.nih.gov/publications/combine/faqs.htm 

8. Disulfiram. MedlinePlus. Updated December 16, 2021. Available from: https://medlineplus.gov/druginfo/meds/a682602.html

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