If you are addicted, medication allows you to regain a normal state of mind, free of drug-induced highs and lows. It frees you from thinking all the time about the drug. It can reduce problems of withdrawal and craving. These changes can give you the chance you need to focus on the lifestyle changes that lead back to healthy living.
Taking medication for alcohol or opioid addiction is like taking medication to control heart disease or diabetes. It is NOT the same as substituting one addictive drug for another. Used properly, the medication does NOT create a new addiction. It helps you manage your addiction so that the benefits of recovery can be maintained.
At Higher Path Living, we support the best evidence-based research and incorporate it in our recovery program. As part of our commitment to help you succeed, we support the use of Naltrexone and Vivitrol in recovery. You will have the opportunity to meet with an addictionologist (a physician board certified in treating addiction) for the necessary testing and further explanation of how medical assistance can work for you.
Please find below information about the use of Naltrexone in treatment for opioid addiction published by SAMHSA (The US Substance Abuse and Mental Health Services Administration).
“It’s not like I woke up one day when I was young and told myself, ‘I wanna be a drug addict. I wanna ruin my life and ruin the lives of those around me.’ I’ve learned now that this is a disease, and when I pick up that first drug, I can’t stop.”
How do you return from the ruin of drug addiction? Most people cannot do it alone. They need help to return to normal, healthy living. One important form of help is called medication-assisted treatment.
There are three equally important parts to this form of treatment:
- Support from family and friends
Naltrexone is one type of medication used for treatment of opioid addiction. Perhaps your doctor or substance abuse treatment provider has recommended it for you, or perhaps you already take it. This booklet gives you the facts you need to know. NOTE: Important words often used in treatment are introduced in this booklet in bold type.
Opioids are drugs that slow down the actions of the body, such as breathing and heartbeat. Opioids also affect the brain to increase pleasant feelings. They get their name from opium, a drug made from the poppy plant.
Opioid medications are prescribed to treat pain and sometimes for other health problems such as severe coughing. Heroin is an illegal opioid that is smoked, snorted, or injected to get a good feeling, often called a “rush” or “high.” People also sometimes seek this feeling by taking large doses of prescription opioids.
If you take opioids, you can become tolerant to them. This means that more of the drug is needed to obtain its effects. It is also possible to become dependent on opioids. This means that if you stop taking them, you will feel sick. This sickness is called withdrawal. Dependence is not the same as addiction, but sometimes dependence leads to addiction.
The signs of addiction are:
- Craving—The mind develops an overwhelming desire for the drug.
- Loss of control—It becomes harder to say no to using the drug. Use is compulsive and continues even though the drug causes harm.
Tolerance and dependence are common side effects of prescribed opioid medication that can be managed under a doctor’s care. Tolerance and dependence also are side effects from misuse of opioids. Addiction is not likely to develop in a person using medication properly, but this sometimes happens. Addiction usually occurs through misuse. Some people are at higher risk of addiction because of their genes, temperament, or personal situation.
Not everyone who uses opioids gets addicted. But it is difficult to stop using opioids after you have become addicted, because the cravings are so strong and the fear of withdrawal is so great.
Opioid addiction is a chronic disease, like heart disease or diabetes. A chronic disease is a medical condition for life. It cannot be cured, but it can be managed. A person with addiction can regain a healthy, productive life.
But if you are like most people, you cannot walk away from addiction on your own. Treatment—the care of medical professionals and substance abuse treatment providers—can help.
Treatment helps you give up the problem drug. It helps you get through withdrawal and cope with cravings. Treatment also helps you change addictive thinking into non-addictive, healthful patterns. It can help you move away from other harmful behaviors, too, such as drinking alcohol or abusing other drugs besides the problem opioid.
Just as important, treatment helps you address life issues you might have that are tied to the addiction, such as feelings of low self-worth, a bad situation at work or home, or spending time with people who use drugs. In short, treatment helps you move into a healthy, addiction-free lifestyle—into a way of living referred to as recovery.
Naltrexone is one of three medications commonly used to treat opioid addiction. The other two are methadone and buprenorphine. Cost varies for the different medications. You may need to take this into account when considering your treatment options.
Naltrexone blocks opioids from acting on the brain, so it takes away the reward of getting high on the problem drug. This feature makes naltrexone a good choice for preventing relapse (falling back into problem drug use).
Naltrexone may not stop drug cravings. If it does not help with cravings, your doctor or substance abuse treatment provider will help you find other ways to reduce them.
Naltrexone comes in pill form. Two trade names for it are ReVia® and Depade®. It is also available as a lower cost generic. You take the pill every 1 to 3 days.
Naltrexone is also available in a new extended-release form that is injected in the buttocks. This extended-release injectable form has the trade name Vivitrol®. The injection is administered by your physician or other treatment provider once a month.
Naltrexone may be a good choice if you are completely past withdrawal and highly motivated to stay in recovery. It also may be recommended if you are in an early stage of opioid addiction. Naltrexone may be prescribed if it is the right choice for you.
Before you are given the first dose of any medication for opioid addiction, your doctor will ask you questions about your addiction, health, and other problems. You will get a drug test—usually a check of urine or saliva. You also will have a physical exam and tests for diseases that are common to people who have been abusing drugs. Your liver will be checked to make sure the medication can be safely taken. If naltrexone is safe and appropriate for you, your doctor may recommend it.
You and your doctor or substance abuse treatment provider decide together on a treatment plan. The plan describes the medication routine, the counseling and other services that will be provided, and the rules that must be followed. These rules will be explained to you, and you will get them in writing.
You must have no opioids in your body before starting naltrexone. Otherwise, withdrawal will be extra strong. You first must go through withdrawal under your doctor’s care. This supervised withdrawal is called detoxification or detox. You can start on naltrexone after detox is completed.
Your doctor will first prescribe a low dose. Your dose levels may be adjusted up as needed. Always take doses exactly as prescribed by your doctor. If you are prescribed the injectable form of naltrexone, be sure to keep your appointments for monthly injections.
You may take naltrexone for days, months, or years—as long as it is needed to prevent relapse. However, you should be checked often by your doctor if you have liver disease.
Naltrexone does not cause withdrawal when you stop taking it. If you are stable in recovery and want to stop taking naltrexone, you do not need to taper off over time. However, you should always consult with your doctor before quitting naltrexone.
Some people who take naltrexone carry a medical card in case they need emergency care. The card explains that they cannot receive medications containing opioids and they will need special care if they are in pain. Ask your doctor whether you should carry a card.
Naltrexone has side effects in some people.
Side effects are feelings of discomfort or sickness that come with taking medicine. Naltrexone has a few mild side effects. Usually these go away after the medicine is taken for a while.
If you have side effects, you should NOT stop taking the medication. Instead, talk with your doctor or substance abuse treatment provider. An adjustment in dosage or a change in medication might help. There are some simple things you can do to reduce side effects, too.
If you are taking naltrexone, you cannot get high from other opioids because the medication blocks the effects. Sometimes people take large amounts of opioids to try to overcome this block. Do NOT do this! It is VERY dangerous and can cause overdose or death.
Naltrexone kept at home must be locked in a safe place to prevent accidental use by others, especially children.
If you are a woman and are pregnant or breast-feeding, you should NOT take naltrexone. Methadone is safer for mother and child.
Liver problems are rare but can occur. If you have a pre- existing liver condition, your doctor should conduct regular tests on your liver.
While taking this medication, you should NOT use other opioid medications such as some pain medications, cough syrups, and diarrhea medicines. The naltrexone will stop these medications from working. You should let doctors and dentists know you cannot have any medications (including shots) that contain opioids.
While taking this medication, you should NOT use illegal drugs, drink alcohol, or take sedatives, tranquilizers, or other drugs that slow breathing. Taking any of these substances in large amounts along with naltrexone can lead to overdose or death.
- Upset stomach or vomiting—Take the pill with food or after a meal. Take an antacid product as directed by your doctor.
- Diarrhea—Drink plenty of water or juice. Also, ask your doctor to recommend an over-the-counter medicine.
- Headache—Use over-the-counter headache medicines according to package instructions.
- Nervousness—Take a walk, take a hot bath, or take deep breaths. If this problem is serious or lasts a long time, tell your doctor or substance abuse treatment provider.
- Sleep problems including tiredness—Take the pill in the morning. Avoid naps. Go to bed at the same time every night. Exercise. Do not drink caffeine after lunchtime.
- Joint or muscle pain—Use over-the-counter pain medicines according to package instructions.
- Serious side effects—For extreme stomach pain, vomiting, or diarrhea, or if the area where you received your injection becomes red or painful, contact your doctor right away. Also seek help if the following side effects appear, because they may indicate serious liver problems:
- Dark or tea-colored urine
- Bad stomachache
- Light-colored bowel movements
- Yellowing in the whites of the eyes
- Yellow skin.
For many people, another important part is counseling: the opportunity to talk with a professional either one-on-one or in a group with others in treatment. Through counseling, you learn about the motivations and behaviors that led to your opioid addiction. You learn to commit to a more healthful lifestyle. You gain support and skills while working with others to manage your recovery long term.
Counseling can provide encouragement and motivation to stick to treatment. It can help you learn how to make healthy decisions, handle setbacks and stress, and move forward with your life.
In group counseling, you connect with others in treatment and make new friends who don’t use drugs. You can get these benefits from support groups, too. These are informal meetings of people facing similar challenges.
Family and friends are important, too. It is very hard to go through recovery alone. Support from family and friends is very important. Love and encouragement can help you make the decision to enter treatment and stick with it.
Some treatment programs offer counseling for your loved ones. They do this because your addiction may have caused pain and anger or feelings of shame and hopelessness.
Counseling is a useful way for family and friends to learn more about your situation, how to help, and how to handle the problems your addiction has caused them. It is a safe place for them to express feelings and to find out what help is available for everyone affected.
There are support groups for families and friends, too. These are safe places to share information and encourage others who have loved ones who are dealing with addiction.
Many people with opioid addiction regain normal, healthy lives. One way they do this is with medication-assisted treatment.
Medication, counseling, and support: together they can help you, your loved ones, and your friends.
“For me, being in recovery is about having a job. It’s about being an active member of my family. It’s about having friends. It’s about having a social network. It’s about having passion in my life again.”
Addiction is a disease. It cannot be cured, but it can be treated with medication, counseling, and support from family and friends. Addiction is NOT a sign of weakness. It is NOT TRUE that all you need to kick addiction is to “be strong.”
The goal of medication-assisted treatment is to recover from addiction. It does NOT replace one addictive drug with another. It provides a safe, controlled level of medication to overcome the use of a problem opioid.
A substance abuse treatment provider must obtain your informed consent (a written agreement) before sharing information about you with others. There are two exceptions to this privacy rule:
(1) If it appears that you may harm yourself or others and (2) if you have been ordered into treatment by the courts. To learn more about your privacy rights, talk to your substance abuse treatment provider.
Recovery is possible. But it takes work. After treatment is finished, everything is NOT automatically fine again. Recovery takes commitment every day, through treatment and beyond.
Naltrexone helps you avoid relapse. It is legal and taken under a doctor’s care. It is NOT just another drug to abuse. Naltrexone is produced under safe conditions and sold legally. There is no risk of getting tainted doses, which can happen with street drugs. You can stop taking naltrexone at any time with no withdrawal or craving. It is NOT addictive. Few people have mood swings when taking naltrexone. It does NOT cause depression. If you have symptoms of depression, talk to your doctor— there may be some other cause.