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Robin Campbell, LMFT, PHD Alcohol use disorder affects people from all backgrounds and can range from risky drinking patterns to severe alcohol use disorder.
Maverick
Clinical Editorial Team
Alcohol use disorder affects people from all backgrounds and can range from risky drinking patterns to severe alcohol use disorder. Many individuals who drink alcohol regularly may wonder when alcohol abuse becomes a medical concern, what treatment decisions are available, and whether alcohol pharmacotherapies such as naltrexone treatment could help. Research from clinical trials, meta analysis reviews, and organizations such as the Mental Health Services Administration continues to shape medication development and effective treatment options for substance use disorders. This guide explains what patients should know about naltrexone for alcohol use disorder, including oral and injectable naltrexone options, common questions, and how this treatment modality may fit into a recovery plan.
Naltrexone is an FDA-approved medication used to help treat alcohol use disorder. It blocks opioid receptors in the brain that play a role in the rewarding effects of alcohol. This action may reduce cravings, lower the urge to keep drinking, and make alcohol feel less reinforcing.
Naltrexone does not treat alcohol withdrawal, and it is not a cure by itself. It works best when paired with therapy, relapse prevention, medication management, and ongoing recovery support. Naltrexone is available as a daily oral tablet or a monthly injection known as Vivitrol.
Alcohol can activate reward pathways in the brain that reinforce continued drinking. One way to understand how naltrexone works in treatment is that it blocks opioid receptors linked to alcohol-related pleasure and reward, which helps blunt alcohol’s reinforcing effects. As cravings decrease, many people find it easier to focus on recovery goals and reduce drinking, not just avoid heavy drinking.
Both forms contain the same active medication but differ in how they are taken. Oral naltrexone is taken daily, while Vivitrol is administered as a monthly injection by a healthcare provider.
Oral naltrexone may work well for people who can consistently take medication each day and take the prescribed dose without missing doses. Vivitrol may benefit people who prefer a long-acting option and want to avoid missing doses.
Alcohol use disorder can affect brain function, decision-making, memory, mood, and impulse control. Long-term alcohol use may also increase the risk of liver disease, heart problems, digestive issues, weakened immunity, and sleep disturbances.
Alcohol can contribute to depression, anxiety, and other mental health concerns. Over time, drinking may become harder to control as physical dependence and cravings increase.
Some people use naltrexone to help reduce episodes of binge drinking, which generally means four or more drinks for females or five or more drinks for males within a short period, or other forms of heavy alcohol consumption. By lowering the rewarding effects of alcohol, the medication may help reduce drinking during these episodes and decrease the amount consumed. Naltrexone is often most effective when combined with counseling, behavioral therapies, and ongoing recovery support. A healthcare provider can determine whether it is an appropriate option based on individual needs.
Naltrexone may be appropriate for adults with alcohol use disorder who want help reducing cravings, preventing relapse, or cutting back on heavy drinking. It may also support people in outpatient treatment, intensive outpatient programs, or recovery services after detox.
Naltrexone is not right for everyone. People using opioids, opioid pain medication, or experiencing opioid withdrawal should not start naltrexone until medically cleared, and people with certain liver concerns may need additional review before treatment.
People must be free from opioids before starting naltrexone to avoid precipitated withdrawal. Using opioids while taking naltrexone can increase overdose risk if someone attempts to overcome the medication’s blocking effects. Healthcare providers may monitor liver function before and during treatment. Individuals should discuss all medications, medical conditions, and substance use history with their provider before beginning treatment.
Naltrexone is one part of a larger treatment plan for alcohol use disorder. It is often combined with therapy, relapse prevention, group counseling, family support, and recovery planning. Many people receiving treatment for alcohol addiction may also struggle with other substances such as opioids, fentanyl, heroin, prescription opioids, cocaine, methamphetamine, benzodiazepines, or marijuana. Integrated treatment can address substance use, mental health symptoms, and recovery goals at the same time.
Medication can help reduce cravings, but it does not address the underlying causes of addiction. Therapy helps people identify triggers, manage stress, improve coping skills, and build healthier habits.
Counseling can also address relationship issues, trauma, depression, anxiety, and other factors that may contribute to alcohol use. Combining therapy with medication often produces stronger long-term recovery outcomes.
Alcohol use disorder affects thousands of adults across Tennessee each year. Excessive alcohol use remains a major public health concern and contributes to emergency room visits, chronic health conditions, accidents, and preventable deaths. Many individuals who need treatment never receive it. Increased awareness, early intervention, and access to evidence-based care can help reduce the impact of alcohol-related problems in Knoxville and throughout Tennessee.
Short-Term
Long-Term
Naltrexone may help reduce cravings and decrease the rewarding effects of alcohol, which can lower the risk of returning to heavy drinking. It is often used alongside therapy, recovery support, and relapse prevention planning to strengthen long-term recovery efforts.
Naltrexone is available as a daily oral tablet or a monthly injection called Vivitrol. Both forms contain the same medication and may help reduce alcohol cravings and support recovery from alcohol use disorder.
Oral naltrexone requires daily use, while Vivitrol is typically administered once a month by a healthcare provider. The best option depends on treatment goals, medical needs, patient preference, and the ability to stay consistent with medication. Treatment length varies, but naltrexone treatment often lasts three to four months, while some patients may need at least 6 to 12 months because treatment durations greater than 3 months may improve outcomes.
Before starting naltrexone, a healthcare provider will review medical history, alcohol use patterns, current medications, liver health, recent opioid use, and the prescribed medicine form before treatment begins. Naltrexone blocks opioids and can trigger sudden withdrawal if opioids are still in the body, so people must be medically cleared before treatment begins.
Alcohol use disorder commonly occurs alongside mental health conditions such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), bipolar disorder, and panic disorder. While naltrexone helps reduce alcohol cravings, therapy and mental health treatment are often needed to address these co-occurring conditions and support recovery.
Naltrexone is often used as part of medication-assisted treatment (MAT), which combines FDA-approved medications with counseling and behavioral therapies. For people with both alcohol use disorder and co-occurring mental health conditions, dual diagnosis treatment may include naltrexone, therapy, psychiatric care, and recovery support to address both conditions at the same time and reduce relapse risk. Research on incorporating alcohol pharmacotherapies often measures efficacy through outcomes such as weighted mean difference in drinking days or heavy drinking reduction.
Family support can strengthen recovery by improving communication, accountability, and understanding. Family involvement may also help identify relapse warning signs and create a healthier home environment that supports long-term recovery goals.
It may be time to seek help if alcohol use is affecting health, relationships, work, finances, or daily responsibilities. People who experience cravings, repeated relapse, withdrawal symptoms, or difficulty controlling drinking may benefit from a professional assessment and treatment.
Many health insurance plans provide coverage for alcohol use disorder treatment, including therapy, outpatient care, intensive outpatient programs, residential treatment, and medication-assisted treatment. Coverage varies by plan, so benefits, deductibles, copays, and provider requirements should be verified before starting treatment.
Naltrexone is one pharmacotherapy that may help some patients reduce alcohol use and support long-term recovery from alcoholism. Whether prescribed as an oral route medication or as extended release naltrexone, treatment should be guided by medical practice, patient preference, health history, and individual recovery goals. Because severe alcohol use disorder, opioid use disorder, substance abuse, and co-occurring mental health concerns can increase health complications, including liver injury, trouble sleeping, and other challenges, it is important to seek medical attention and discuss all medications, including methadone and other medications, with a qualified provider. Understanding how naltrexone works and whether it is an appropriate treatment option can help people take the next step toward recovery.
At New Hope Healthcare, as an in-network provider we work with most insurance plans, such as:
If you or a loved one are struggling with mental health challenges or substance abuse, seeking treatment and emotional support is crucial. Consulting a doctor can provide the necessary support and guidance for your teen. Reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Effective medication management is a crucial part of the treatment process to ensure safety and success. Give us a call at 866-799-0806.
Visit SAMHSA for more information.
Naltrexone may begin working within a few days, but results vary. Many people notice reduced cravings and fewer urges to drink during the first few weeks of treatment.
Naltrexone does not cause illness if alcohol is consumed, but drinking may reduce treatment progress. The medication works best when combined with a recovery plan focused on reducing or stopping alcohol use.
Neither option is universally better. Vivitrol is a monthly injection, while oral naltrexone is taken daily, and the best choice depends on a person’s needs, preferences, and ability to stay consistent with treatment.
No. Naltrexone is a tool that helps reduce cravings and support recovery, but ongoing treatment, therapy, and lifestyle changes are often needed for long-term success.
Naltrexone can trigger sudden opioid withdrawal in people who still have opioids in their system. A provider should confirm that opioids have been discontinued before treatment begins.
Yes. Research shows naltrexone may help reduce heavy drinking, lower cravings, and decrease the risk of relapse when combined with counseling and other recovery supports.
](https://www.samhsa.gov/substance-use/treatment/options/naltrexone)
](https://library.samhsa.gov/product/tip-49-incorporating-alcohol-pharmacotherapies-medical-practice/sma13-4380)
](https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/021897s061lbl.pdf)
](https://www.cdc.gov/alcohol/excessive-drinking-data/index.html)
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