Naltrexone: Uses, Alternatives, and What You Need to Know

When you're trying to break free from alcohol or opioid dependence, naltrexone, a medication that blocks opioid receptors in the brain to reduce cravings and prevent relapse. Also known as Vivitrol when given as a monthly injection, it doesn't get you high, doesn't cause physical dependence, and is often used alongside counseling. Unlike methadone or buprenorphine, which activate opioid receptors to ease withdrawal, naltrexone simply shuts them down. That means you can’t get high from opioids while taking it — and if you try, you’ll feel nothing. For alcohol, it cuts the pleasurable rush, making drinking less rewarding over time.

This makes naltrexone a key tool in medication-assisted treatment, a proven approach combining drugs with behavioral therapy to treat substance use disorders. It’s not a cure, but it gives people space to rebuild habits without the constant pull of cravings. It’s used by people who’ve already gone through detox and are ready to stay sober — not for those still actively using. If you take opioids while on naltrexone, you risk overdose because your tolerance drops, and the drug blocks the effects you expect. That’s why it’s only prescribed after full withdrawal.

It also works for alcohol dependence, a chronic condition where drinking becomes compulsive despite negative consequences. Studies show people on naltrexone are more likely to stay abstinent than those on placebo. It doesn’t stop you from drinking entirely, but it makes the experience less satisfying. That small shift can be enough to break the cycle. Some people take it daily as a pill; others get a monthly shot, which helps with adherence.

There are alternatives, like acamprosate for alcohol or buprenorphine for opioids, but naltrexone stands out because it doesn’t carry the risk of misuse. It’s not addictive. It doesn’t need daily dosing if you go with the injection. And it’s safe for long-term use. But it’s not for everyone — if you have liver damage, your doctor will monitor you closely. And if you’re still using opioids, it can trigger sudden withdrawal.

What you’ll find in the posts below are real-world comparisons and practical insights. You’ll see how naltrexone stacks up against other treatments, what side effects people actually experience, and how it fits into daily life. You’ll also find guides on where to get it safely, how to talk to your doctor about it, and what to expect when you start. No fluff. No marketing. Just what works — and what doesn’t — for people trying to take back control.