Naltrexone is a drug used to treat people who are dependent on opiate or opioid drugs such as heroin. Naltrexone has the ability to antagonize, or reverse, virtually all the effects of opiate/opioid drugs. It blocks the pleasurable or rewarding effects of opiate drugs, so that addicts do not feel a craving for the drugs. This antagonist effect is long lasting. In addition, naltrexone does not produce any pleasurable effects on its own. As a result, the patient has little incentive to misuse the medication and will not become dependent on it.

Treatment with naltrexone is most successful when combined with a program of counseling and other rehabilitation services. Addicts who are employed and able to manage their lives, and who are highly motivated to beat their addiction, have the best treatment results. This is especially true when addicts face severe economic or legal consequences for failing treatment. For example, health professionals with an addiction problem must get treatment in order to keep their medical licenses. These addicts typically take naltrexone regularly for several years (known as maintenance treatment) and remain abstinent from opiates. Some programs have reported five-year success rates as high as 95 percent. In contrast, most street addicts have unstable living situations and support their drug use through criminal activity. Typically, these addicts refuse to take naltrexone. If they do begin treatment, in general they quickly drop out. Naltrexone's ineffectiveness for this type of addict is probably due to the drug's lack of pleasurable effects. Many such addicts prefer maintenance treatment with methadone, an opiate drug that produces some desirable effects.

In the 1990s researchers studied naltrexone as a treatment for alcoholism. Alcoholic men who had gone through detoxification were given naltrexone. Naltrexone reduced the likelihood that these men would return to alcohol use. A 1999 study showed that naltrexone reduces the desire and craving for alcohol. However, it can sometimes increase the negative side effects, including headaches. Naltrexone is especially effective in the treatment of alcoholism when use of the drug is combined with therapy to change the patient's behavior. Naltrexone is also being studied experimentally as a possible treatment for cigarette smoking and eating disorders.

See Also

Alcohol Treatment: Medications; Heroin Treatment: Medications; Opiate and Opioid Drug Abuse; Tobacco Treatment: Medications.