Naltrexone

[sfgirl]

I take Naltrexone and have since the day I quit drinking. It is a drug that has ample research backing up its effectiveness at curbing alcohol cravings. Unlike Antabuse, I can actually drink on it without throwing up or other nasty effects. However, hopefully it diminishes cravings that I have so I won't drink. I did relapse once for one night but luckily got back to sobriety the next day. I am not sure how much the medicine has helped but I am sure it has not hurt. I am uninsured (ugh, health care in this country) but it only costs me $40/month at the Costco pharmacy which is a hell of a lot cheaper than drinking. I definitely work a strong program of recovery and don't really think about the pills much. But I just read this in Alcohol Alert, a newsletter published by the government agency NIAAA so I thought that I would bring it up in case anyone is struggling and might need an initial boost to help stay sober. I truly feel that the more tools the better.

From Alcohol Alert
NIAAA Publications

Perhaps one of the greatest disconnects between research and practice involves the use of medications to treat alcohol-related disorders. For example, clinical trials suggest that naltrexone helps reduce the frequency of drinking and the severity of relapse among alcohol-dependent patients (2).

Although there are occasional reports of no effects (3), large-scale analyses of clinical trials have continued to support an improvement in treatment outcomes with the use of this medication (4,5).

Training materials on the use of medications in alcoholism treatment also are available. A Center for Substance Abuse Treatment (CSAT) Treatment Improvement Protocol was developed to provide detailed clinical guidance on how to use naltrexone in alcoholism treatment (2), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) published as part of its COMBINE Monograph Series the Medical Management Treatment Manual, which details the rationale and use of both naltrexone and acamprosate (6).

Despite the availability of training materials for professionals and consistent reports of significant reductions in alcohol use, medications such as naltrexone are not commonly prescribed. Members of the American Academy of Addiction Psychiatry and the American Society of Addiction Medicine prescribed naltrexone to only about 1 in 7 (13 percent) of their patients (7,8). A survey of counselors and physicians specializing in addiction medicine (9) found that few counselors (5 percent) recommended naltrexone to most of their patients, and more than half (54 percent) never suggested that patients try it. A higher percentage of physicians prescribed naltrexone for patients. Eight of 10 physicians (80 percent) reported current or prior use of naltrexone with patients, but only 11 percent prescribed it “often,” and only 4 percent prescribed it for “almost all patients” with alcoholism or alcohol abuse problems.

If naltrexone is effective, why isn’t it used? Organizational support was the strongest predictor of whether counselors recommended naltrexone. Patient access to insurance benefits also influenced the use of medications. Counselors treating patients who had Medicaid coverage were more likely to promote the use of naltrexone, which was on the Medicaid formulary in the study States (9). Counselors whose patients paid for their own treatment or whose treatment was funded through State and Federal funds were less likely to recommend naltrexone to patients. Among physicians, those involved in research and those in organizations that promoted naltrexone use were more likely to prescribe the medication. Physicians in recovery themselves were the least likely to prescribe naltrexone (9).

[suki44883]

I used it in early recovery, but then, I went to a medical detox facility and they started me on it and sent a scrip for it home with me. I used it for 2-3 months after that and eventually stopped. I'm not sure how much the naltrexone helped because I was pretty gung ho about not drinking. I did just recently celebrate one year of sobriety, so I know something's working!

[Zencat]

Originally Posted by sfgirl

I truly feel that the more tools the better.

I'm of the same mind. I unitize a wide array of strategies that bring me better emotional/mental/physical health.

[Katie09]

Well, Naltrexone is another angle to the whole deal and may be very useful to some. At times, simply wanting to quit and being addicted are at odds. I know for me I am ADDICTED to alcohol. Therefore, I believe that I need some medical intervention to get me past my addiction. After that, I can look at other options. It's just like detox. When you go through it the primary focus is on giving one meds to come down. It's a medical intervention for acute withdrawal. Well, in post-acute withdrawal there can be other medical interventions. Thanks for the info.

[jowinbo]

hey, ty, i have been using that for bout a month.........it does help blessings

[sfgirl]

Another study from the NIAAA website:

Naltrexone or Specialized Alcohol Counseling an Effective Treatment for Alcohol Dependence When Delivered with Medical Management

The first paragraph:

The medication naltrexone and up to 20 sessions of alcohol counseling by a behavioral specialist are equally effective treatments for alcohol dependence when delivered with structured medical management, according to results from "Combining Medications and Behavioral Interventions for Alcoholism" (The COMBINE Study). Results from the National Institutes of Health-supported study show that patients who received naltrexone, specialized alcohol counseling, or both demonstrated the best drinking outcomes after 16 weeks of outpatient treatment. All patients also received Medical Management (MM), an intervention consisting of nine brief, structured outpatient sessions provided by a health care professional. Contrary to expectations, the researchers found no effect on drinking of the medication acamprosate and no additive benefit from adding acamprosate to naltrexone. Effect of Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence appears in the current issue of the Journal of the American Medical Association,Volume 295, Number 17, pages 2003-2017.

acamprosate=generic of Campral

[RV GTO]

I was just prescribed Naltrexone.

[Rad44]

I have been using Naltrexone for over two months as part of my IOP for Alcoholism. I feel it has help me greatly relative to past attempts to quit drinking. It has totally eliminated all physical cravings but more importantly it provides relief from obsessive thinking about Alcohol. When coupled with Group and Individual Thearapy this makes a very effective combination and serves to ease much of the anxiety and angst of early sobriety. Additionally it is non-addictive (unlike Suboxone for Opiates) and has virtually no side effects. Only one pill in each morning is needed.

[sfgirl]

RV GTO—

Let us know if you can tell a difference either way.

Rad and Jowinbo—

Good to know of your positive experiences! I am sort of in the same boat as Suki, it has been really hard for me to actually know if it has made a difference. But I am still taking it 8 months later because well I am sober and I am not going to fix what ain't broke.


And I think this is really important to highlight:

Additionally it is non-addictive (unlike Suboxone for Opiates) and has virtually no side effects.

[Bella_Fox]

Glad to see this thread. I was just prescribe Naltrexone, and I've been a bit nervous about it because, though my doctor says it has few serious side-effects, someone else told me she got very depressed on it. Anyway, I have to wait a few days because I took some Tylenol w/codeine a few days ago (for pain, not for recreational reasons) and all the lit says it can cause major withdrawal within minutes of ingestion for up to 7-10 days after taking an opiate. So... good to see that I don't need to be as worried when I do start it.