How Does Naltrexone Work For Alcohol Addiction?
Approved in 1994, Naltrexone became the second FDA approved drug for the treatment of alcohol use disorder. This drug doesn’t prevent you from drinking alcohol, like Antabuse does, but it is thought to block the pleasure you feel when you drink.
When we drink alcohol, endorphins are released in the brain which feel pleasurable. They bind to opioid receptors and trigger the release of dopamine in our reward system. As someone regularly drinks larges quantities of alcohol, changes happen to the brain’s reward system. The body will actually release more endorphins than required, which causes more dopamine to be released and a greater amount of euphoria.
Naltrexone is an opioid receptor antagonist that binds to opioid receptors more strongly than alcohol does, and it prevents alcohol from interacting and causing the release of endorphins. Several studies have shown that it reduces relapse. It reduces the pleasure we feel from drinking, without affecting our ability to get drunk.
Naltrexone works best in people who have a specific gene that allows them to experience euphoria from alcohol and drugs. We don’t all experience alcohol in the same way, and some people have a specific receptor that makes alcohol and drugs feel fantastic for them. When alcohol interacts with this receptor, huge amounts of endorphins are released. Naltrexone also interacts with this receptor, and blocks alcohol from binding, thus preventing the release of endorphins. The idea is it makes alcohol feel meh instead of fabulous. If you don’t have this specific receptor, then naltrexone can’t block it, and the drug isn’t going to be very effective.
The Sinclair method was developed by Dr. John Sinclair and unlike other treatment methods it allows you to continue drinking at the start of treatment. The idea is that you take Naltrexone at least one hour before you begin drinking. The problem with this is you have to take it one hour before you start drinking.
If you really want to drink, are you going to willingly choose to take something that you know will prevent alcohol from making you feel good? Additionally, even if you do take it and alcohol stops feeling good, you still know that the only reason it doesn’t feel amazing to drink anymore is because you’re taking a pill. If you stop taking it, then it will restore all of the positives that you believe alcohol is bringing you.
Learn more about historical and current medical treatments of alcohol use disorder in episode 47 of the Sober Powered Podcast
Sources
Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism, Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. HHS Publication No. (SMA) 15-4907. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
SAMHSA. Evidence for the Efficacy of Naltrexone in the Treatment of Alcohol Dependence (Alcoholism). Addiction Treatment Forum. 2002.
Gianoulakis C. Influence of the endogenous opioid system on high alcohol consumption and genetic predisposition to alcoholism. J Psychiatry Neurosci. 2001;26(4):304-318.
Cite this article
Tietz, G. How Does Naltrexone Work for Alcohol Addiction. Sober Powered. 2022
