Naltrexone Therapy for Addiction Recovery

Dr. Chaim B. Colen

This opioid blocking agent can save lives.

What is Naltrexone Therapy?

Naltrexone is non-addictive/non-narcotic FDA approved medication that blocks the brain’s receptors for opioids/alcohol, thus blocking the high from opioids/alcohol and reducing the patient’s cravings. Naltrexone when compared to naloxone, commonly known under the brand name Narcan, is a long acting opiate blocker. 

Narcan has rapid opioid reversal action and is used to expediently reverse drug overdose. Its onset is within minutes and its effects last 60-90 minutes. Naltrexone has a slower onset of action, lasts 24-48 hours and should only be used once the patient has fully detoxed from opioids and should not be construed as a cure.

Patients need to use naltrexone in conjunction with an addiction treatment program in order to assist with their underlying psychological aspects of addiction.

What other types of Substance Use Disorders is Naltrexone Used For?

Naltrexone is used mainly for opioid and alcohol dependence. 

Naltrexone acts in a similar way for those suffering from alcoholism as those suffering from opioid dependence. Naltrexone will block the euphoric effects and feelings of intoxication, thus diminishing the want and need to drink alcohol. Naltrexone completely blocks the mu opioid receptor, thus, despite relapse, the patient has no effects of overdose nor euphoria and realizes that he/she just wasted their money. It breaks the reward seeking cycle. Research has shown that when a patient is on naltrexone, they have a decreased urge to drink, and develop longer periods of alcohol abstinence. It also interferes with a patient’s desire to drink even if he/she slips and has a drink while on Naltrexone.

What are the types of Naltrexone?

Naltrexone comes in 3 different forms; pills, injections and implant. The pill form, called ReVia/Depade, is taken orally every day and is most effective when taken at the same time every day. The injection, called Vivitrol, works by a slow release of naltrexone throughout a 1-month period. After 1 month the effects wear off and the patient needs to see his/her doctor for another dose. Lastly, the implant is surgically sewn into the lower abdomen wall and lasts up to 6 months.

Why use Naltrexone?

Naltrexone belongs to a class of drugs known as opioid antagonists (opioid blocking agent) and is non-addictive and non-narcotic. On the other hand, traditional opioid withdrawal medications include drugs such as methadone and Suboxone and are a part of the class of drugs known as opioid partial agonist/antagonists (both stimulation/blocking agents). Although methadone and Suboxone are opioids, they partially inhibit the high you get from drugs like heroin, oxycodone and morphine. However, these drugs too, are a narcotic and addictive. Therefore, those suffering from opioid addiction are substituting one addiction for another. With naltrexone, patients can focus on their recovery with minimal cravings and no risk of chemical dependency for naltrexone. By reducing the cravings and blocking the high of opioids and alcohol, patients are less likely to relapse.

What is a Naltrexone Implant?

The Naltrexone implant is a compounded medication that has been implanted under local anesthesia. Naltrexone Implants require a small surgical incision in the lower abdomen in front of the hipbone, which is then closed with 3-4 stitches by the surgeon. The implant will slowly release the medication over 3-6 months depending on the dose. 

This medication blocks the effects of all opiates including heroin, methadone, morphine, codeine, and oxycodone, fentanyl, as well as blocking cravings associated with alcohol addiction, and allows for excellent recovery. It is recommended that the patient have another implant 6-months after the first one.

Why use the Naltrexone Implant?

Using the implant instead of the oral tablets ensures the patient receives a steady dose of the medication and safeguards against patients forgetting to take the tablets or stopping the medication all together (compliancy). This also allows the patient to focus on their recovery and prevents relapse, which is common in the early stages of recovery. While on the Naltrexone Implant, patients are unable to get high and overdose from opiates. We have seen that patients are more likely to complete rehab and commit to their aftercare programs by attending meetings and reaching out to their sober supports.

What are the side effects of the Naltrexone Implant?

Since this is a minor surgical procedure, patients may have some slight irritation, inflammation or infection at the implant site. Furthermore, if the patient has not fully detoxed from opioids, they will experience instant withdrawal symptoms. Withdrawal symptoms will also occur if the patient hasn’t been fully weaned off of more traditional medications such as Suboxone or methadone. 

In order to safeguard against these side effects, we closely monitor the patient and will not use the implant if they have not fully detoxed from opioids.

How long should someone use the Naltrexone Implant?

Research has shown that it takes at least one year if not longer for the brain to heal from addiction, therefore we recommend the patient to be on Naltrexone for at least one year. 

Furthermore, it allows the patient to fully immerse themselves in their recovery process, build strong support groups and acquire the tools necessary for long-lasting recovery.

What Happens after Naltrexone Implantation?

Detoxing is just the beginning of recovery and the Naltrexone Implant helps with the early stages of intense cravings and high relapse potential. Since substance use disorders are a complex brain disease that can take a year or longer for the brain to heal, we require all of our patients to commit to treatment programs such as individual counseling, group therapy and family therapy programs after the Naltrexone Implant. 

How do I know if the Naltrexone implant is right for me?

In order to be eligible for the Naltrexone implant, some guidelines have been setup to ensure minimal risks from using the Naltrexone implant.

  • The patient must be willing and able to provide informed consent to receive the implant.
  • The patient is willing to completely withdraw from opioid use.
  • A urine drug screen has been performed with no positive results for opiates or other street drugs.
  • A lack of adverse reaction to Naltrexone, which must be verified by administering oral naltrexone in tablet form for 3-5 days.

The Naltrexone Implant might be a good choice for you if you have a history of relapsing or the circumstances in your life make it difficult to stay consistent with the oral medication. 

Does Insurance Cover the Cost of the Implant?
Most major insurance companies cover the cost of the implant. If insurance is unavailable then cash pay options are accepted.

If you or a loved one is interested in the Naltrexone Implant please contact one of our specialists at Inspire Palm Beach at 866-993-3869 or email info@inspirePalmBeach.com visit www.InspirePalmBeach.com for info.

Inspire Palm Beach is a 22-room neuroscience-based wellness and recovery facility focusing on addiction recovery, mental health and cognitive health. Using holistic and neuroscience methodologies, it is the first and only neuroscience center in Palm Beach that is treating addiction where it starts – in the brain. 

Dr. Chaim B. Colen is a Neurosurgeon, Author, Educator, Eclectic Artist, Entrepreneur and Medical IT Guru. He is past national chair of the Young Physicians Representative Section of the Council of State Neurosurgical Societies (CSNS). He has very diverse talents; strong interest in entrepreneurship, medical device innovation, HIPAA compliance, medical advocacy and legislation, substance abuse detoxification, real estate investments and new business enterprise. He is an international speaker, has authored many books, journal articles, and held many TV interviews including the Today Show and Discovery Channel.