Naltrexone is an Opioid antagonist (opiate receptor blocker). It is used in Addiction Psychiatry for different indications. These include Opiate Addiction, Alcohol Dependence and Gambling Addiction.

Opiate Addiction

Opiate addiction and it’s treatments depend a lot on stage of recovery and the motivation. Whilst Methadone, Subutex/Suboxone are very useful substitute treatments, for people who become opiate free, Naltrexone is used to remain opiate free as it helps in reducing the cravings and acts as a blocking drug, so that any use of opiates on top of Naltrexone are ineffective. Naltrexone can be used in tablet form (daily) with supervision. For some people an injectable depot that lasts up to a month is available and some people benefit from Implants (3 monthly). Our recommendation is to be on Naltrexone for up to a year, irrespective of its form- oral, depot or implants.

Alcohol Dependence

Naltrexone blocks the opioid system in the brain which in turn is responsible for the blockade of the pleasure and reward pathways in the brain which get activated when someone is drinking alcohol. With Naltrexone, the number of heavy drinking episodes can be reduced and the amount of alcohol can be reduced as well. It is also useful in reducing the cravings. It can be used in a tablet form (daily) or an injectable depot (1 monthly).

Forms

Tablet- Needs to be taken daily (preferably under supervision).

Depot- A monthly injection is available for people who don’t prefer or find it difficult to take a tablet everyday.

Naltrexone Implants- Implants manufactured in UK will be available with us soon, which release Naltrexone slowly in the body to keep the levels high enough to be active. The effects of the implant generally last up to 3 months and we recommend a new implant at the end of three months. A urine screen is taken before the implant procedure to ensure that there are no opiates in the body. The implant procedure is a simple procedure where under a local anaesthetic, a small incision up to 2 cm is made in the lower abdomen and the implant inserted under the skin. The incision is closed with 2-3 dissolvable sutures. Normally people are ready to go home within a maximum of an hour of the procedure. Antibiotics for 3-5 days are prescribed to avoid any infections. The implant is normally palpable under the skin (can be felt) like a small bump which gradually shrinks as the medication is released.