Based on recent questions, I realized that it had been some time since I wrote about Naltrexone and its use a medical support. So, here goes an update.
First, what is it? Naltrexone is a benign anti-craving medication that many of our clients have found useful as a short term adjunct to their work with us. Medically, it is an “opioid receptor blocker” which means you no longer get a “buzz” from drinking. That lack greatly reduces drinking’s appeal for most people. That in turn makes it easier to focus on addressing whatever you’ve been medicating rendering excessive alcohol use unnecessary as well as undesirable.
Next, how can I get it? Any physician, and in many states, any Physician’s Assistant or Nurse Practitioner can prescribe Naltrexone. No special license or specialty is required. However, because it is not widely known, many prescribers will claim otherwise. Therefore, I’ve added a link to an Alaskan handout for the medical community which you can share with your provider.
Side effects? The most common side effects are mild nausea and a modest sedative effect. Both are usually mild, if at all, and the former is usually eased by starting with half doses (25 mg) for the first 6 days and nearly all side effects disappear within a week as your body adjusts. Most people, however, don’t experience any side effects.
Problems? As with any medication, a small number of people do not tolerate Naltrexone and must abandon its use. But again, it isn’t a magic bullet, only a short term support for 3 to 6 months. As an opioid blocker it also blocks the use of opioid pain killers and should be stopped a few days before any procedure which may involve the use of such – for example, my recent knee surgeries or a root canal.
Cessation? You can stop Naltrexone at any time – no weaning is required.
Cautions? You should stop drinking 3 days prior to beginning Naltrexone to avoid being thrown into withdrawal. Withdrawal is rare but can be life threatening but to put it into proportion, in 35 years of work I have only had 3 clients who required medically assisted detoxification. If you can go more than 12 hours without developing any symptoms, you are unlikely to do so. Most symptoms can be alleviated by a taper down schedule and a short course of an anti-anxiety medication such as Ativan. Again, talk with you physician!
Is it worth it? For most of you, yes. The benefits can be significant and the cost is negligible.
Conclusions? Read the handout I’m providing. Confer with your provider. Talk to one of us. Give it a try.