The smell didn’t so much creep up on me as it did slap me upside the head. Stale alcohol has always burned my nostrils like the way I imagine acid dissolves flesh. Without a thought, I asked if he’d run out of Naltrexone. “Yup,” he said. “It’s been since about 8 days since I’ve taken it.”
“Hmm,” I said. “And when did you pick up a drink?”
“Well, I’d say about 4 days ago…”
As I suspected, once his 60 day supply of naltrexone ran out, the urge to drink would overcome him and he’d relapse right back to drinking himself numb. The reason I was certain is that over the last few months, his personality was much different than it had been over the last few days. I noticed it on a phone call, but when I visited him, my suspicions were confirmed: The latest curveball life threw him triggered him to what he knew best.
However, a few weeks before, life pitched a similar curve and he knocked it right out of the park. There was no lamenting on his part, no despair clouding his judgement. He accepted the issue for what it was and worked through a plan to deal with it. Because of the history I have with him, it was obvious that the Naltrexone was modulating the cravings and impulses to use alcohol. Without it, over 20 years of alcohol as coping mechanism is just too much to bear for him.
Though Naltrexone is primarily used to combat Opiate addiction, various studies have shown Naltrexone to be effective in treating in treating alcohol abuse because it blocks the opiate receptors in the brain, which prevent feeling pleasurable effects from opiates and alcohol. It was the central component studied in a book called, “The Cure for Alcoholism;” in the book, the author recommended using it, even if the patient is still drinking. Patients featured in the book showed that they drank way less while on Naltrexone (Vivitrol, Narcan) and were able to maintain abstinence for far longer.
I recommended that he renew his Rx as soon as possible, as the despair that has followed him around was as present as the alcohol cloud in his room. I strongly believe that the Naltrexone was a benefit to him on his quest for sobriety and I urge medical professional to consider this medication as an adjunctive tool to use in the treatment of alcohol use disorders.