What You Need to Know About Taking Naltrexone

By Layne A. Gritti DO, Adult, Addiction, and Perinatal Psychiatrist, Sweetgrass Psychiatry

As a psychiatrist, I often discuss medications that can help manage various conditions, especially those related to substance use disorders. One such medication is naltrexone, an opioid blocker that is widely used for treating alcohol use disorder (AUD) and opioid use disorder (OUD). It can also play a role in chronic pain management and weight loss when combined with bupropion.

In this post, I'll explain how naltrexone works, its benefits, and important considerations for anyone taking it, especially in emergency situations.

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What is Naltrexone?

Naltrexone is a non-opioid medication that works by binding to opioid receptors in the brain. By doing this, it blocks the effects of opioids, including the euphoric and sedative sensations produced by substances like heroin, morphine, and codeine. As a result, naltrexone helps suppress cravings and prevents relapse in individuals recovering from opioid addiction or alcohol dependence.

Here are some key facts about naltrexone:

• It is not an opioid and does not cause a “high.”

• It is not addictive and does not lead to dependence.

• It does not cause withdrawal symptoms if you stop taking it.

• Naltrexone will not make you sick if you drink alcohol.

• If you take opioid pain medications while on naltrexone, they won’t work as well, or may not work at all.

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Uses of Naltrexone

Naltrexone has several important clinical uses:

1. Alcohol Use Disorder (AUD): It helps reduce the craving for alcohol and supports abstinence by blocking the reinforcing effects of alcohol.

2. Opioid Use Disorder (OUD): For those recovering from opioid addiction, naltrexone blocks the pleasurable effects of opioids, making it easier to avoid relapse.

3. Chronic Pain Management: Some physicians use naltrexone in lower doses (low-dose naltrexone, or LDN) to help with chronic pain, especially in conditions like fibromyalgia.

4. Weight Loss: Naltrexone, in combination with bupropion, can be prescribed for weight loss. This combination works by reducing hunger and food cravings.

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Important Considerations for Naltrexone Use

While naltrexone is effective, there are critical things to keep in mind:

1. Effect on Pain Medication: If you are taking naltrexone and experience a medical emergency or have a scheduled procedure where opioid pain relief is required, opioid pain medications may not work as expected. You might need a higher dose of opioids for pain relief, which increases the risk of deeper and prolonged respiratory depression (slowed breathing). For this reason, it is essential to inform your healthcare providers that you are on naltrexone. If you are having a planned procedure where opioids will be required, please talk to your naltrexone prescriber.

2. Emergency Protocol: In the event of an accident or emergency surgery, it’s crucial that the medical team knows you're taking naltrexone. They need to plan for alternative pain management strategies or adjust the type and dosage of opioids to ensure effective treatment.

3. Medical ID and Emergency Information: Because of the complexity of pain management in naltrexone users, carrying a medical ID is strongly recommended. Your medical ID should include information about your naltrexone use, helping first responders and healthcare professionals make informed decisions in an emergency.

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How to Prepare for Emergencies

Since naltrexone affects how your body responds to opioids, it’s important to carry emergency contact information at all times. Here are a few ways you can do this:

• Medical ID Jewelry: Wearing a bracelet or necklace indicating your naltrexone use can alert emergency responders immediately.

• Smartphone Medical ID: Most smartphones allow you to store medical information that can be accessed even if your phone is locked. Be sure to include naltrexone as part of your medication list.

• Wallet Card: Carry a printed card with your essential medical and contact information. This card should explain that you are taking naltrexone and provide instructions for emergency medical personnel.

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Sample Wallet Card for Naltrexone Users

You can download and print the sample card below to carry with you in your wallet: https://www.vivitrol.com/content/pdfs/emergency-pain-management-card.pdf

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Conclusion

Naltrexone is an invaluable tool for multiple health conditions. However, it’s essential to be aware of the potential complications it poses in emergency medical situations. By being prepared with a medical ID and emergency information, you can ensure that healthcare providers have the information they need to care for you safely.

If you have questions or concerns about taking naltrexone, always speak with your doctor to ensure that it’s the right choice for your health. If you are interested in receiving help for you addiction / substance use disorder and reside in South Carolina, call Sweetgrass Psychiatry, located in Mount Pleasant SC at (843) 800-1303.