Naltrexone is a prescription medication that blocks the efficacy of opioids. Typically, people use naltrexone to combat opioid use disorder (OUD). But some people use naltrexone to address alcohol use disorder (AUD).
In 1995, the U.S. Food and Drug Administration approved naltrexone as a treatment for alcohol dependence.[3]
How Does Naltrexone Work To Treat AUD?
The exact way in which Naltrexone works to decrease cravings for alcohol is not clear. It is believed that, as an opioid antagonist, it blocks opioid receptors which are associated with cravings and reward centers in the brain. Perhaps this is the way in which it decreases cravings for alcohol.
Naltrexone mutes your ability to feel pleasure from alcohol. When it’s working, you’ll feel less inclined to drink and have fewer cravings to drink, and you’ll stop drinking more easily.[2]
Does Drinking On Naltrexone Make You Sick?
No, it does not.
Historically, several of the medications that were used to treat alcohol use disorder – specifically a medication called Disulfiram – worked by making the person feel very ill and sick if they drank alcohol while taking the medication. Therefore, some people may get confused and worry that Naltrexone will likewise make them feel sick.
However, this is not true. This is not the way in which Naltrexone works. In fact, studies suggest that Naltrexone works better than older medications like Disulfiram to treat alcohol use disorder, because instead of simply disincentivizing people from drinking by making them feel ill, it instead works more deeply to alter a person’s brain chemistry and their desire to drink. These days, Naltrexone is considered a more effective treatment for AUD than older medications like Disulfiram, which are rarely prescribed.
Can You Feel Drunk on Naltrexone?
Yes, you can. Naltrexone does not dull the effects of alcohol on patients if they do drink on it. People can still feel the impact of alcohol while taking naltrexone.[5]
Anecdotally, some people say that drinking while on naltrexone don’t feel a rush of pleasure or the other pleasurable effects of drinking the way they would without the medication, and this may be true to a certain extent.[2] However, this is not the primary way that Naltrexone works. It does not simply make you feel “not drunk” when drinking alcohol. Primarily it works by decreasing your desire to drink overall. If you drink on Naltrexone, particularly if you drink heavily, you will still “get drunk”.
What Will You Feel if You Drink on Naltrexone?
Some people say that the effects of alcohol on Naltrexone are slightly blunted. However, this is not true for everybody. If you drink on Naltrexone, you should still expect to experience the intoxicating effects of alcohol, such as dizziness/lightheadedness, euphoria, impaired inhibitions, slurred speech, impaired coordination, etc.
Treating AUD with Naltrexone
Naltrexone makes alcohol less rewarding and lessens cravings over time. Naltrexone has been proven to reduce the number of days people with AUD drink alcohol. And it could help to reinforce abstinence in people who quit drinking.[3]
Some people are hesitant to use Naltrexone because they are under the misconception that it is dangerous to drink while on it, and they worry they will cause damage to their help if they take the medication and then “mess up” and drink alcohol anyway.
THIS IS NOT THE CASE AT ALL! In general, it is safe to drink while on Naltrexone. The goal is not to immediately become abstinent, but rather to eventually decrease the amount you are drinking over time, and potentially even stop altogether if that is your goal.
Treatment with naltrexone for AUD is of course most successful if it’s part of a treatment program that includes the following components:[4]
- Counseling
- Alternate therapies
- Peer support
- Support group work
Most people use naltrexone for three or four months, but some need even longer. It can be safe to take Naltrexone for years to prevent relapse to alcohol use in certain individuals. [5]
The Bottom Line: Using Naltrexone to Stop Drinking
It’s incredibly difficult to quit drinking. Alcohol is ubiquitous in our society. If you’ve tried to quit drinking on your own and can’t, naltrexone can help.
Here are the facts about drinking while on Naltrexone:
- Naltrexone is different from several older medications that were once used to treat alcohol use disorder by making you feel physically sick if you drank while taking them, such as Disulfiram.
- It is safe to drink while on Naltrexone, and many people do, at least at first, as they work on slowly reducing the amount they drink.
- If you do drink while on Naltrexone, the “intoxicating” effects may be slightly less, but you can still “get drunk” if you continue to drink heavily while on Suboxone.
- If you do drink while on Naltrexone, you will not cause yourself harm or make yourself feel sick.
If you think naltrexone may be right for you, talk with your doctor. You’ll need a prescription to get started.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More
- Alcohol Facts and Statistics. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics. March 2022. Accessed November 2022.
- Naltrexone for Alcoholism. American Family Physician. https://www.aafp.org/pubs/afp/issues/2000/0315/p1891.html. March 2000. Accessed November 2022.
- Naltrexone for the Treatment of Alcohol Use Disorder in the Primary Care Setting. U.S. Pharmacist. https://www.uspharmacist.com/article/naltrexone-for-the-treatment-of-alcohol-use-disorder-in-the-primary-care-setting. August 2018. Accessed November 2022.
- Evidence About the Use of Naltrexone for Different Ways of Using It in the Treatment of Alcoholism. Alcohol and Alcoholism. https://academic.oup.com/alcalc/article/36/1/2/137995. January 2001. Accessed November 2022.
- Naltrexone. Alcohol and Drug Foundation. https://academic.oup.com/alcalc/article/36/1/2/137995. December 2021. Accessed November 2022.
- Naltrexone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone. September 2022. Accessed November 2022.
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