Naltrexone Case Study

Naltrexone is a non-opioid FDA-approved medication to prevent relapse after opioids have been eliminated from the body. It has no addiction potential. Naltrexone works by reducing cravings and blocking the “high” should the recovering addict relapse. Naltrexone best serves patients with completed other treatments, such as detoxification, medication-assisted treatment with methadone, medication-assisted treatment with buprenorphine, or Rehabilitation.
Naltrexone is available in two formulations: a 50 mg daily oral tablet (Revia®, others) and a 380 mg extended-release once-monthly intramuscular injection (Vivitrol®). Unlike the tablet, which can be easily self-discontinued, the intramuscular injection is more reliable because it guarantees protection for a full month.
• Do not want to use another opioid (methadone or buprenorphine) as part of their treatment.
• Have adequate financial resources or medical insurance to pay for the medication.
• Are also alcoholic. Vivitrol is also FDA-approved to treat alcoholism.
However, there are restrictions for starting or using naltrexone:
• Administering naltrexone to persons who have recently received an opioid will immediately induce withdrawal symptoms.
• Naltrexone should not be administered to persons with serious liver or kidney problems, are under age 18, or are over age 65 (not adequately studied in these age groups).
BOTTOM LINE
Medication-assisted treatment with naltrexone is best utilized after patients have completed other treatments. Naltrexone serves as “insurance” to help the recovering addict remain clean and sober after opioids have left the body. As examples, naltrexone might be used for twelve months after completing medication-assisted treatment with buprenorphine, during or after Rehabilitation, or after an addict completes a jail or prison