Using Naltrexone To Decrease Alcohol Relapse

Annually, around 1.5 million people in the USA seek treatment for alcohol and its related problems. In 1994, naltrexone became approved for the treatment of alcoholism by the U.S. FDA. Naltrexone works by blocking opioid receptors found in the brain as well as stemming the endorphin-mediated reinforcing effects of drinking alcohol. There is great  evidence to suggest and prove  that naltrexone has power to significantly reduce alcohol relapses to heavy drinking, the frequency of drinking, quantity of alcohol consumed  by  those who do drink, and also alcohol craving. Naltrexone is vitally beneficial in helping those patients who cannot abstain so as to reduce their drinking patterns, breaking the vicious self-destructive cycle of alcoholics which causes one to drink one drink which leads to the other together with allowing more quality time for psychosocial therapy to be productive. Naltrexone has demonstrated efficiency in a various alcohol-treatment settings using adjunctive psychosocial therapies that provide patients with motivation to stay in treatment, overcome relapses, and also take medications. Individualized and flexible naltrexone dosing can be of great benefit. Longer-term naltrexone therapy exceeding more than three months may be most effective, and naltrexone might be used on an as-needed, “targeted,” basis indefinitely. Alcohol is a very complex substance that affects several chemical systems in the brain.  It is presumed that, when an alcoholic drinks, the brain’s opioid system releases endorphins that trigger the reinforcement that is responsible for enticing one to drink more. Unlike other drugs that were earlier used to treat alcoholism, naltrexone is not addictive in nature and composition and does not in any way react aversively with alcohol.

·        Monthly naltrexone injection to control alcoholism

A monthly dose of Naltrexone, under different trade names, is already in use to treat alcoholism. The monthly dose is   a more convenient approach than current daily oral doses. Using naltrexone combined with counseling could help reduce heavy drinking in people suffering from alcoholism. Because of problems with adhering to daily oral doses of naltrexone, the effectiveness found in treating alcohol dependence with a once-a-month injection of naltrexone improves long-term treatment results. According to a previous study in 2005, naltrexone showed efficiency for treatment of alcohol dependence. However, adherence to daily oral doses can be hectic, and therefore, utilization of oral naltrexone have been limited.

·         Naltrexone should be used with caution in patients with liver disease

For a person suffering from hepatitis or liver failure, naltrexone should not be prescribed.it is recommended that liver function tests such as ALT, AST, gamma glutamyltransferase and bilirubin must be conducted before naltrexone treatment begins and at intervals after the treatment begins. In healthy patients without liver disease, intervals of 1, 3, and 6 month scan be ideal for the tests, then yearly thereafter. Liver function tests should be performed more frequently especially if baseline liver function test results are high, a history of hepatic disease is confirmed, or if a potential hepatotoxic medication is prescribed and if the patient is taking doses higher than 50 mg/day. Naltrexone should be used cautiously in patients whose serum aminotransferase results are greater than five times the upper limit of normal. 

• Cannot be used for people using opioid for pain management

A careful drug use history and urine toxicological screening should also be done so as to confirm abstinence from opioids, including prescribed pain medications, as well as a lack of opioid dependence before initiating treatment. Comprehensive urine tests should be carried out to measure methadone and other opioids. However, urine testing can be subject to error because typical urine screening tests may not cover all opioids and samples can be tampered with to affect the results.

It is important to note that Administration of naltrexone should not be initiated until the patient has been opioid-free for between 7 to 10 days and that the naloxone challenge test for opioid withdrawal is negative. If no abstinence signs are observed following a preliminary dose of naltrexone 25mg, the rest of the daily dose is administered. Maintenance treatment regimen with naltrexone can be flexible where patients may receive naltrexone 50mg on weekdays and 100mg on Saturday or 100mg every other day, or 150mg every third day. Naltrexone is not suitable for use in patients with acute hepatitis or liver failure and should not be used in patients receiving opioid analgesics. The major active effect of naltrexone is on opioid drugs, which is one class of drugs used primarily to treat pain but is also found in some prescription cough preparations. This is because Naltrexone will block the effect of normal doses of this type of drug. There are many non-narcotic pain relievers that can be used effectively while you are undergoing treatment with naltrexone. Anyway, naltrexone is likely to have little impact on other medications patients commonly used in patients such as non-opioid analgesics (e.g., aspirin, acetaminophen, and ibuprofen) and antibiotics, and allergy medications.one should inform a physician of whatever medication he or she is currently taking so that possible interactions can be examined. Since naltrexone is metabolized by the liver, treatments that affect liver function may influence the dose of naltrexone.

A point to note is that naltrexone neither reduces the effects of alcohol that impair coordination nor judgment. Also Naltrexone’s effects on blocking opioids occurs shortly after the first dose is administered. Furthermore, findings confirm that the effects of naltrexone in helping patients remain abstinent and avoid relapse to alcohol use also occur early. However, Naltrexone should not be used with expectant women, people with liver or kidney damage or with patients who cannot practice abstinence for at least 5 days prior to commencing treatment. Also, people who are dependent on opioids such as heroin or morphine must cease their drug use at least 7 days prior to starting naltrexone.

Other than side effects, which are usually for a short period as well as mild, patients normally report that they are unaware of feelings of being on this medication. Naltrexone usually has no psychological effects and patients do not feel funny. It is also not addictive. While it reduces alcohol craving, it does not interfere with the experience of other types of pleasure.

Using Naltrexone To Decrease Alcohol Relapse

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