Naltrexone: What It Is, How It Works, and What You Need to Know

When you hear naltrexone, a medication used to treat alcohol and opioid dependence by blocking the brain’s reward response. Also known as Vivitrol when given as a monthly injection, it doesn’t get you high, doesn’t cause dependence, and doesn’t treat withdrawal. Instead, it helps you stay on track by taking away the pleasurable effects of alcohol or opioids if you use them. This makes it a key tool in recovery — not a cure, but a way to reduce cravings and prevent relapse.

Naltrexone works by sitting on opioid receptors in your brain like a lock, stopping alcohol and opioids from turning on the reward system. If you drink while on naltrexone, you won’t feel the usual buzz. If you use opioids, they won’t hit like they used to. That’s not punishment — it’s rewiring your brain’s response. People using it for alcohol dependence, a chronic condition where drinking interferes with daily life and health often report losing interest in drinking over time. For those managing opioid use disorder, a condition where opioid use becomes compulsive despite harm, naltrexone removes the high, making it easier to focus on therapy and rebuilding life.

It’s not for everyone. You must be fully detoxed before starting — using naltrexone while opioids are still in your system can trigger sudden, severe withdrawal. That’s why doctors test for opioids first. It’s also not a magic pill. It works best when paired with counseling, support groups, or lifestyle changes. Many people use it after completing rehab, or while working through outpatient programs. The monthly shot, Vivitrol, helps with adherence — no daily pills to forget. But the oral version is cheaper and just as effective if taken consistently.

Side effects are usually mild — nausea, headaches, tiredness — and often fade after a few weeks. Some people feel emotionally flat at first, but that’s often because their brain is adjusting to not being flooded with artificial highs. Long-term use is safe, and studies show people who stick with it for six months or longer have much higher rates of sustained recovery.

You’ll find posts here that dig into how naltrexone compares with other treatments like buprenorphine or acamprosate. You’ll see real stories from people who’ve used it, tips on staying consistent, and how to talk to your doctor about making it part of your plan. There’s also info on what to do if you slip up, how to handle side effects, and why some people stop — and how to get back on track. This isn’t just about the drug. It’s about what comes after: rebuilding trust, regaining control, and finding a life where you don’t need substances to feel okay.