Long-Established Drug Shows Promise for Reducing Alcohol Consumption

Recent studies continue to validate naltrexone, a medication that has been on the market for decades, as an effective option for people looking to reduce their alcohol consumption.

Naltrexone, a prescription opioid pill, was first approved by the FDA to treat opioid dependence in 1984. Ten years later, in 1994, regulators expanded its approved uses to include alcohol use disorder. The medication is now available in two forms: a daily pill and a monthly injectable therapy, which received FDA approval for alcohol use disorder in 2006 and for opioid use disorder in 2010.

The drug works by blocking opioid receptors in the brain, effectively preventing the “euphoric” effects typically associated with opioid use. For alcohol users, naltrexone curbs cravings and reduces the pleasurable sensations that drinking provides.

“Naltrexone can be used to assist with reducing alcohol cravings and reduce the pleasurable effects from alcohol ingestion, which can help those prone to binge-drinking to consume less volume,” explains Dr. David Campbell, clinical director and program director at Recover Together, a behavioral health and addiction treatment facility in Oregon.

According to Campbell, the medication is particularly useful for certain types of drinkers: those who experience strong cravings, individuals who tend to drink excessively once they start, and people who drink primarily for reward or relief rather than out of habit.

Jessica Steinman, chief clinical officer at No Matter What Recovery in Los Angeles, describes naltrexone as “an incredibly helpful and life-saving tool” for those struggling with alcohol use disorder.

“Currently, in our society, many people are looking to get medication-assisted help from overconsumption of certain things or behaviors, including food, cigarettes and now alcohol,” Steinman notes. “Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol and allows cravings to be minimized. It can assist in telling the brain that alcohol isn’t wanted.”

Steinman adds that the drug can also benefit individuals with a “healthy” relationship with alcohol who simply want to reduce their consumption. However, she cautions that for those with alcohol use disorder or any type of dependence, drinking less is not considered a solution. “We do not suggest moderation in any way for people struggling with alcohol use disorder,” she emphasizes.

Like most medications, naltrexone comes with potential side effects. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), common reactions include nausea, vomiting, headache, sleep disturbances, dizziness, fatigue, anxiety, loss of appetite, and joint or muscle pain. These effects are typically mild and often improve as the body adjusts to the medication.

In rare instances, patients may experience more severe effects such as liver issues, allergic reactions, breathing difficulties, or mental health impacts.

Dr. Campbell stresses an important precaution: “The most important thing when taking naltrexone for alcohol use is to ensure that there is no concurrent use of opioids, as taking naltrexone when using opioids can induce precipitated withdrawal, a very uncomfortable event.”

The potential impact of naltrexone is significant when considering alcohol consumption statistics in the United States. CDC data shows that more than 50% of U.S. adults drink alcohol, with approximately 17% classified as binge-drinkers and 6% drinking heavily. Each year, around 178,000 deaths nationwide are linked to excessive alcohol use.

“Heavy alcohol consumption and binge-drinking can lead to many health problems and make chronic health conditions worse, so reducing alcohol intake can really improve health,” says Donita Robinson, Ph.D., an associate professor of psychiatry at the UNC School of Medicine.

Robinson emphasizes that naltrexone works best when combined with counseling or other forms of therapy. She also reiterates that people taking opioid medications, including certain painkillers, should avoid naltrexone as it can block their effectiveness and potentially trigger opioid withdrawal.

Naltrexone is available only with a prescription from licensed healthcare providers such as primary care physicians, addiction medicine specialists, or psychiatrists. Health officials caution against purchasing the drug online or without a prescription due to risks of counterfeit or unsafe products.

Those interested in exploring naltrexone as an option should consult with a healthcare professional who can assess the safety of the drug based on their specific medical history and current health status. Steinman advises that potential users should “make sure they have their goals and intentions in line before using a medication like this.”