Doctors should prescribe Naltrexone for treating alcohol use disorders. Here’s why:

naltrexone

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.

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6 comments

  1. Thank you so much for this article. I to take naltrexone and I thought about stopping using it once it ran out because I don’t feel like going to the doctor and get it refilled but after reading your article perhaps I should do that because I haven’t quite reach 60 days yet.

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    1. If I were you — i’d get it refilled. The thing is that your body may be dependent, which means it needs to learn to “be” without drugs/alcohol. I appreciate you sharing your experience — i wish you all the success and health this world can provide!

      Liked by 1 person

  2. Quote:
    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.

    In the book, the author Dr Roy Eskapa, in association with Dr David Sinclair, showed that naltrexone is FAR, FAR more effective ONLY when taken one prior to drinking.

    Over 120 clinical trials have shown that naltrexone along with abstinence does not extinguish the cravings – hence why if naltrexone is stopped, the cravings inevitably return and drinking more often than not, follows.

    Using naltrexone one hour prior to drinking means that the endorphins released by drinking are targeted and blocked by naltrexone, leaving other normal life activities feeling good on the days that someone doesn’t drink.

    Over a period of some months (typically 6-9 months) the brain learns to understand that drinking is no longer rewarding but other things are. The pendulum swings away from alcohol – cravings lessen until they eventually disappear.

    This is called pharmacological extinction of the AUD, and from this point on someone can chose to remain abstinent or drink at safe levels (as long as they take the pill one hour beforehand so the brain doesn’t learn to associate alcohol with reward again).

    More complete information and resources on this method can be found by going to the not-for-profit websites http://www.cthreefoundation.org or if you live in Europe, http://www.cthreeeurope.com

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  3. I have very good results in treating alcohol with combined Naltrexone implants and counselling. Patients mostly don’t take the naltrexone tablets and naltrexone without counselling is generally ineffective.

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    1. Well done, Hugh, I am very glad that you had such good results. Anyone recovery from this terrible addiction is brilliant. I never care how anyone recovers, as long as they do 🙂

      However, in my experience of taking 200+ people through The Sinclair Method using oral naltrexone or nalmefene, there generally hasn’t been much issue about compliance in terms of patients not taking their tablets. It does crop up occasionally, but certainly not as often as you expect when you first consider the question of would someone suffering from AUD take a pill that removes the ‘rush’ from the drinking. One of the things that I always point out at the beginning is that it is important to have a solid foundation of understanding and commitment at the beginning. Why are they taking this tablet? What will it achieve? How important is compliance to the method?

      Also, clinical testing (such as those done in 2001 and 2002) concluded that oral naltrexone or nalmefene was ‘safe and effective, especially in family history positive alcoholics, without extensive counselling’.

      If someone feels that counselling would help them, then absolutely it should be followed up during treatment, but it isn’t actually necessary to the scientific and medical process that these medications stop the reward re-inforcement from alcohol drinking, which ultimately causes pharmacological extinction of the cravings. That is something that happens deep within the brain and as long as compliance is happening, it is something that no-one can influence either way.

      Across Europe, where this method has been a recognised treatment since 2013, most countries have made counselling a pre-requisite to receiving the treatment, but the counselling that is suggested isn’t counselling as you would imagine it – it is brief intervention counselling focussed on ensuring compliance, establishing goals and then monitoring progress on the medication. If further counselling is required to establish WHY someone has been drinking to such dangerous levels, then it is offered of course, and so it should be 🙂

      Like

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