Naltrexone, which goes by the trade names ReVia and Vivitrol, is a medication that was initially designed to address issues with opioid abuse. It may also be useful in reducing cravings for alcohol.
Naltrexone is one of three medications the U.S. Food and Drug Administration (FDA) has approved to treat alcohol use disorders.
There are minor differences between ReVia and Vivitrol.
ReVia must be taken daily, whereas Vivitrol injections may last for a week.
ReVia is an opioid antagonist medication that binds to opioid receptors in the brain and reduces the effects associated with opioid drugs and alcohol. By binding to these receptors, it also reduces any cravings or urges a person will have to use opioids or alcohol.
An opioid antagonist medication like ReVia does not produce any type of the psychoactive effects that drug abusers typically seek.
Essentially, this medication has no real potential for abuse, but you will need to get a prescription for it. It is not listed as a controlled substance.
Naltrexone was approved for treatment for opioid use disorders in 1984, and research studies have suggested that it may reduce cravings for opioids. The research also suggests that the injectable form of naltrexone, Vivitrol, may work better at reducing cravings for opioids than the pill form, ReVia.
Due to its success in some research studies in reducing cravings for opioids, researchers wanted to find out if naltrexone could also reduce cravings for other drugs. This led to using naltrexone to treat alcohol use disorders.
Research studies have suggested that naltrexone is moderately effective in reducing cravings for alcohol. The overall body of research indicates that using naltrexone in the treatment of alcohol use disorders may:
Research findings indicate that naltrexone should be used for at least three months. It is more effective in reducing alcohol use if it is used while you are in a formal substance use disorder treatment program.
Like many of the medications that are designed to control cravings for alcohol or to reduce overall alcohol use, research studies have suggested that compliance with taking the drug is one of the biggest obstacles to its success. If you do not use the drug, it cannot work for you.
Some people may forget to take ReVia, or they may intentionally skip taking it. This is why many clinicians suggest using the long-acting injectable form of naltrexone, Vivitrol, instead of ReVia.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that the following are the most common side effects associated with using naltrexone products like ReVia:
It is not recommended that pregnant women use naltrexone products.
Some studies find that ReVia may reduce urges to drink alcohol, whereas others find no significant effect.
Regardless, ReVia will work best for you if you are already abstinent from alcohol and opioids for at least five to 10 days before starting the medication.
Research studies and SAMHSA also advise that anyone using a naltrexone product should not take opioid drugs.
You should not use opioid medications if you are taking ReVia, even if you have a prescription for them, because naltrexone diminishes the effects of opiates. You may attempt to take more of the opioid than you should, leading to an overdose. If you are prescribed opioids for pain and are taking ReVia to treat alcohol abuse, discuss the situation with your physician.
You can drink alcohol while taking ReVia, but it is suspected that ReVia will limit the amount of alcohol you will want to drink.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that the following will happen:
Because some research studies do not find that ReVia significantly reduces the urge to drink alcohol and does not promote abstinence from alcohol, some clinicians have suggested that ReVia may be best used by individuals who are still drinking to reduce their alcohol intake. One of these approaches is the Sinclair Method.
In this approach, it is suggested that you take naltrexone about an hour before you plan to drink alcohol. The approach claims to be able to significantly reduce your alcohol intake and cravings to drink more alcohol once you start drinking.
There appear to be no recorded significant dangers of drinking alcohol while taking naltrexone. There is research that suggests that the drug may be more effective in reducing alcohol intake if it is taken before drinking as opposed to using it and attempting to remain abstinent from alcohol. This research also needs to be replicated.
ReVia is an opioid antagonist medication that may reduce your cravings to drink alcohol and/or may reduce the amount of alcohol you drink. It is not designed to be a first-line or stand-alone treatment for alcohol use disorders. It should be used in conjunction with a formal alcohol use disorder recovery program that includes the use of other medicines, therapy, and participation in support groups like Alcoholics Anonymous.
ReVia can help you get on the road to recovery, but it will not make you stop drinking.
You should not use opioid medications while you are taking ReVia. If you drink alcohol while you are taking ReVia, you may find you do not want to drink as much alcohol as you normally would.
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