Naltrexone:  No Cravings for Alcohol from Day One

by David Heward

I know:  If you've tried to quit drinking before, this claim will probably sound "too good to be true."  And we've all heard the old adage, "If it sounds too good to be true, it's probably NOT true."  That's generally pretty good advice, especially for some of the "miracle cures" you see advertised on the Internet or TV.  

But just for a moment, try to suspend that disbelief about the effectiveness of naltrexone... and assume that the headline really is true.  

That within one hour after taking your first naltrexone pill, the nagging, persistent, seemingly endless craving for alcohol (that has plagued all your previous attempts to quit drinking,) simply vanishes into thin air, and doesn't return.  Poof...  just like that!

Now, if you can have your choice, and it's just that easy, which way do you think you would prefer to get sober?  With the cravings... or without the cravings... for alcohol?  It's not even a contest, is it?  Getting sober without the cravings would clearly be the BETTER WAY.  Right?

I can hear you thinking: "Ah, but you haven't yet proved to me that it really is possible, and that it's really as easy as taking a few pills."   And you're right.  

If there were some way that I could prove it to you using only words, you can believe that I would do it... right here, right now. One of the best summaries I know of about naltrexone is called Tip 28, which is a publication of the federal governments Substance Abuse and Mental Health Services Administration. and it's available to order in print form or you can download it from their website. (See below.)  

I could also provide you with tons of research studies, hundreds of testimonials written by satisfied users, and all the technical scientific explanations of how the medication works...  and soon I will try to do ALL those things elsewhere on this website...  but the bottom line is that you're not REALLY going to believe it until you experience it for yourself.  Isn't that right? 

So let me ask you this:  why not give the naltrexone a try,  and find out for yourself whether or not the medications will work for YOU?  After all, what have you got to lose?

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Tip 28:
Naltrexone and Alcoholism Treatment

TIP 28 is a publication of the Center for Substance Abuse Treatment, Substance abuse and Mental Health Services Administration, of the U.S. Department of Health and Human Services. TIP 28 is available in print from by calling NCADI at 1-800-729-6686. A free copy will be mailed within a few days.  Ask for DHHS Publication No. (SMA) 98-3206.

TIP 28 is also available for viewing or for download via the Internet web site: 
 
National Clearinghouse for Alcohol and Drug Information. 

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The following description of TIP 28 is an excerpt entitled "What is a TIP?"

"This TIP, Naltrexone and Alcoholism Treatment, presents current knowledge about the use of Naltrexone, an opioid antagonist medication first synthesized in the 1960s and subsequently developed by the National Institute on Drug Abuse (NIDA). This medicine was initially developed to treat opiate addiction. Subsequently, research sponsored by the National Institute on Alcohol Abuse and Alcoholism, which research is still ongoing, found that Naltrexone can help prevent relapse to alcohol use disorder when combined with traditional treatment modalities. 

"Naltrexone, when combined with appropriate psychosocial interventions, relieves the craving for alcohol (and opiates) and decreases the relapse rate to heavy use. Naltrexone has been proven safe for most adults except pregnant or nursing women, the very obese (at doses higher than herein recommended for daily use), and probably those with acute hepatitis; women of child-bearing potential must be tested monthly for pregnancy.

This TIP describes the medication itself, its mode of action, possible common adverse effects, and interactions with other medications. A separate chapter on the clinical use of Naltrexone presents guidelines for selecting patients who may benefit from Naltrexone and for starting and maintaining these patients on Naltrexone. Issues for program managers and administrators, including staff education and procedures for getting new drugs on health care system formularies, are presented in appendixes."

Additionally, another excellent resource for information on recovery in general (plus information on many medications including Naltrexone) is the book "Recovery Options" by Joseph Volpicelli, M.D., Ph.D , and Maia Szalavitz.  The book should be available at your local bookstore or library, or you can order it online now from Amazon.com.

One of the most common questions that people ask about naltrexone is:  "If this stuff is really so great, why isn't everybody else using it?"  The answer to that question is really a  long and very interesting story...  and I hope to provide more on that subject in the very near future on this website.  But in the meantime, reprinted below is a section from Tip 28 on that very topic.

TIP 28:
Naltrexone and Alcoholism Treatment: Physicians Guide

Chapter 4   (Page 17)

Why Isn't Naltrexone More Widely Used?

Naltrexone has demonstrated efficacy as an important adjunct to the treatment of alcohol dependence, and it is available for general practitioners to prescribe. Yet it has not been widely accepted or tried. The media promoted naltrexone intensively when it was initially approved by the FDA for use in the treatment of alcoholism. The drug’s manufacturer used standard, but limited, marketing techniques to publicize the drug. Yet the field has been slow to adopt the use of naltrexone.

There may be several reasons for this. First, because the initial studies were relatively small and ongoing research was pending, some practitioners have adopted a wait-and-see approach. The additional costs associated with naltrexone may also serve to limit its use. Finally, it has been extensively documented that there is typically a long lag between an invention or a new research finding and its adoption and widespread use by individual practitioners or programs and organizations in the field (Backer, 1991; National Institute of Mental Health [NIMH}, 1971.)

Even though the Federal Government spends millions of dollars annually to support carefully selected research and service demonstrations as well as medications development, many practical, effective, and innovative new technologies and procedures languish in published articles in scientific journals without further application.

In completed or ongoing research, naltrexone has been used successfully as an adjunct to day hospital treatment, supportive psychotherapy, cognitive-behavioral relapse prevention therapy, primary care counseling, and 12-Step facilitation therapy and support groups. Yet there is much resistance to pharmacotherapy from third-party payers, some addiction clinicians, and some self-help-oriented individuals who view the use of medications in addictions treatment as substituting a pill for self-empowerment and taking responsibility for the disease.

Some consider the cost of naltrexone a barrier. Naltrexone costs approximately $4.50 per day, or $400 for a 3-month period. Additional costs include follow-up LFTs. In settings where patients do not routinely get physical examinations, the costs of these examinations are added to the treatment costs. The daily cost of naltrexone, however, may be less than the cost of alcohol used by most patients, depending on which of the above costs are incurred by the patient.

Naltrexone and the Formulary

The formulary and the formulary system are tools that health care organizations use to improve the quality and control the cost of drug therapy (American Society of Hospital Pharmacists, 1991). A health care organization’s pharmacy and therapeutics (P&T) committee has a key role in maintaining the formulary system, which constitutes a continually revised compilation of drug products that have been approved for use within a health care organization or system (American Society of Hospital Pharmacists, 1983.) Pharmacies do not stock products that are not on their formularies. If a physician prescribes such a drug, a pharmacist is responsible for discussing the request with the prescriber and determining whether an alternative formulary product can be used.

Naltrexone may not be on the formulary in many health care settings. After a drug has received FDA approval for treatment of a particular condition or disease, any licensed physician may prescribe it for that purpose, and any licensed pharmacist may dispense that prescription, on a patient-by-patient basis. Naltrexone is thus theoretically available to any patient who demonstrates a need for it.

[Note: This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated.]

Naltrexone Links

The History of Naltrexone

How Naltrexone Works (from Wikipedia)

Frequently Asked Questions about Naltrexone

MORE Good News!

Besides naltrexone, there's now another new medication which is also a great tool in the battle against alcohol dependence:  Campral® (or it's generic name acamprosate).  Fortunately, it's not a case of only using either one or the other, and we recommend for most people that they use both medications to gain the different benefits of each.  

Click here for more information on Campral© 

and/or visit the Campral website located at www.campral.com.