Is Naltrexone a Controlled Substance?

No, Naltrexone is not a controlled substance or a narcotic, which means any doctor or provider can prescribe it. [1]

Naltrexone (also called by its brand name “Vivitrol”) is an opioid antagonist medication used to treat both opioid use disorder (OUD) and alcohol use disorder (AUD). It blocks the euphoric effects of these substances and doesn’t cause a high. 

Is Naltrexone a Narcotic?

Why Isn’t Naltrexone a Controlled Substance?

A controlled substance is a drug that is regulated by the government, whether that applies to making the drug, possessing it, or using it.

Illegal drugs and prescription medications can be controlled substances, and they are divided into five schedules: Schedule I, Schedule II, Schedule III, Schedule IV, and Schedule V. The schedule a controlled substance falls under depends on its acceptable medical use as well as misuse and dependence potential. [1]

Naltrexone is a prescription medication for the treatment of alcohol use disorder and opioid use disorder and is not considered a controlled substance. It has a proven medical use with no risk of misuse or dependence potential, and you can’t get high on it. 

Because it’s an opioid antagonist, it actually blocks the pleasurable effects of alcohol and opioids like heroin, which is why it is beneficial in treating opioid use disorder and alcohol use disorder.

How Is Naltrexone Regulated?

While naltrexone isn’t a controlled substance, it’s not sitting on pharmacy shelves either (“over the counter”). Instead, it’s a prescription medication that you must visit a doctor to get. However, it is far easier to access and less regulated than another OUD medication, methadone, which must be accessed through special clinics that are approved to dispense methadone.

Naltrexone can be prescribed by any physician or provider. There is no diversion or misuse potential with naltrexone.[2] But it’s still a prescription medication that, like all medications, can cause side effects in some people. 

Ideally, it should be used in combination with other evidence-based treatment modalities, such as therapy and rehab, to help patients recover from a substance use disorder. 

The Difference Between OTC Medication, Prescription Medications, and Controlled Substances

Naltrexone is a non-narcotic prescription medication, but not a controlled substance.

OTC Medications

A medication that is over-the-counter (OTC) is a medication that can be purchased at any pharmacy without a prescription. Usually, these medications are very safe for general use. For example, Tylenol, ibuprofen, cough syrup, vitamins, etc. can all often be purchased over the counter.

Prescription Medications

A prescription medication is any medication that requires a prescription from a licensed medical professional. These medications are also generally safe but may require some education or counseling about potential risks and side effects. 

For this reason, a prescription is necessary to ensure that the patient has met with the doctor and received education about how to properly take the medication and monitor for any worrisome side effects.

Controlled Substances

A controlled substance can be either an illicit drug like LSD or heroin or a prescription medication with misuse potential, such as Percocet, Vicodin or Xanax.

Prescription medications that fall under the Controlled Substances Act (CSA) have some degree of misuse, diversion, or dependence potential. People may misuse these medications to get high or mix them with other substances to enhance the euphoric effects.

In order to prescribe controlled substances, a physician must have an active DEA license. The reason for this is that DEA licensed providers have received additional training in how to properly administer substances that are potentially dangerous or addictive. 

All opioids are considered controlled substances, including opioid medications that are actually used to treat OUD, such as methadone, buprenorphine and Suboxone. 

What is the Difference Between Naloxone and Naltrexone?

Naloxone and naltrexone sound similar. They are both opioid antagonists. 

Naloxone (Narcan)

The main difference is that naloxone (Narcan) is a fast-acting antagonist that blocks the effects of opioids immediately (within minutes) whose effects wear off quickly. It is used primarily to reverse an opioid overdose. For this reason, most states do sell it “over the counter” without a prescription, so that anybody who has a personal history of opioid use or a friend or family member with opioid use can access it and have it in case of an emergency.

Naloxone is also combined with buprenorphine in the form of Suboxone, which is used to treat OUD. The naloxone helps to deter misuse of the medication.

Naltrexone

Naltrexone, on the other hand, is a slower acting opioid antagonist, and will not immediately reverse an overdose the way that naloxone will. Naltrexone, unlike naloxone, is used primarily as a long-term treatment to prevent opioid or alcohol misuse, and requires a prescription from a medical doctor. 

How to Find a Naltrexone Provider

Since naltrexone isn’t a controlled substance, doctors don’t need special training or licenses to prescribe it to their patients. You should be able to visit any qualified medical doctor and get a prescription for this medication. You can visit your physician in person or even make a virtual appointment and order your naltrexone prescription online.

If you have insurance, make sure to find an in-network provider who accepts your insurance plan. You may also want to check if your plan covers naltrexone for OUD or AUD.

In addition, most addiction treatment facilities, if you are already in a program, offer Medication for Addiction Treatment (MAT), including naltrexone. Many programs have addiction treatment specialists on their staff who can prescribe these vital medications to support your recovery. If your primary care doctor won’t give you the drug, it could be a sign that you should enroll in a specialized treatment program that does provide naltrexone.

Remember, a prescription alone isn’t enough to address your substance misuse. Comprehensive treatment that combines medications and behavioral therapy is the best strategy for achieving sustained recovery.

With the right help, you can build a healthy, balanced life in recovery. Ask your doctor if naltrexone might be a tool for you in helping you reach your recovery goals.