Rehab 4 Addiction

Heroin withdrawal can cause some really unpleasant symptoms. Heroin is also one of the most addictive drugs. That’s why there is a real market for medication which can help people stop using heroin and keep them from relapsing.

In this page, we discuss one of the most popular drugs used for this purpose: naltrexone.

What is naltrexone, and how does it work?

Naltrexone is a medication which bonds with the same neuroreceptors in the brain as heroin. When heroin bonds with these neuroreceptors, it causes a blissful high. However, when naltrexone bonds with these neuroreceptors, it does not give you a high.

The upshot of this is that naltrexone both prevents cravings and ruins any potential high. It prevents cravings by replacing heroin in the bond with the brain’s neuroreceptors. It also ruins highs. If someone were to start taking heroin again, the naltrexone would prevent them from feeling anything.

In summary, then, naltrexone has two effects: blocking highs and stopping cravings. Both of these effects are very useful for reducing heroin usage.

Heroin withdrawal

Medications like naltrexone are necessary because opiate withdrawal is really hard. Quitting opioids causes your body to go through lots of nasty symptoms.

These can include:

  • Abdominal cramping
  • Agitation
  • Anxiety
  • Diarrhea
  • Dilated pupils
  • Insomnia
  • Muscle aches
  • Nausea and vomiting
  • Sweating

Your body goes through these symptoms because it comes to rely on heroin during addiction. When its supply of heroin is cut off, it goes into meltdown. It takes it about a week to get used to not having access to heroin.

Cravings

Cravings are the desire to go back to using a drug. They are a part of any withdrawal process. Until your body gets used to not having access to a drug, it’s going to want that drug.

Cravings are dangerous because they can cause a relapse. It’s very difficult to resist the urge to abuse a drug when you are going through severe withdrawal symptoms.

Drugs like naltrexone aim to block those cravings. If they can do so, that makes withdrawal a lot easier.

How do people take naltrexone?

Naltrexone can be taken in three different forms: a tablet, an injectable solution, and an implant.

A pill or an injection lasts for between two and four days, after which you need to take it again. On the other hand, an implant lasts for between three and six months. This means there is no risk of forgetting to take the pill. Nor is there a risk of relapsing once the pill has stopped working.

Naltrexone implants are inserted into the abdominal wall. They stay there for between three and six months, slowly releasing naltrexone into the body. You can get naltrexone implants in most inpatient rehab centres.

What are the advantages of naltrexone implants over alternatives?

There is more of a risk of forgetting to take a pill, whereas with an implant you are guaranteed a steady supply of naltrexone.

Generally speaking, patients tend to do better with naltrexone implants than alternatives. Studies such as this one support this view. [1]

We think this may have something to do with the commitment involved in getting an implant. Once you have the implant, there is no going back.

You are more or less forced to abstain from opioids since naltrexone blocks you from getting high. You also do not have to make a decision every day as to whether to take your medication.

How is the naltrexone implant inserted into the body?

In order to get the naltrexone implant into the body, an operation takes place. This is nothing to be afraid of. What happens is this: the patients lie down on a hospital bed.

The surgeon prepares a patch of skin, usually around the abdomen area. They use an antiseptic solution for this. Then they will give you a local anaesthetic. After that, they will make a small channel in the skin for the implant.

The implant will normally look a bit like a tablet or a pallet. It gets inserted into the skin, and then the surgeon stitches up the wound and adds a bandage.

After surgery, the patient needs to look after the bandage. This is to make sure the implant does not cause an infection. They will need to replace the bandage regularly.

The stitches are taken out after a week. The patient must steer clear of sports and manual lifting for eight weeks following the operation.

Are there any drawbacks to naltrexone?

Naltrexone is a great option, but it does have limitations. For instance, it may reduce cravings, but it does not block them completely. You will still need to find strategies for coping with those cravings even if you get a naltrexone implant. It also causes symptoms of its own, which we will discuss later on.

These include nausea, headaches and insomnia. Finally, it creates a risk of relapse. Someone with an implant, desperate for a hit, might decide to use heroin.

In order to get high, they need to take a bigger dose than normal, because of the naltrexone in their veins. A bigger dose may lead to an overdose.

Is naltrexone a cure for addiction?

In a word: no. Naltrexone is not a silver bullet that kills heroin addiction. It is one component of effective treatment. It helps a lot with the physical side of addiction.

But there is still the mental side of addiction to consider. Naltrexone will not cure your anxiety, or help you come to terms with your trauma. For that you need therapy.

Therapy is essential for dealing with the underlying issues at the heart of heroin addiction. There is no replacement for a full course of rehab therapy.

What are the side effects of naltrexone?

We mentioned earlier that there are some side effects to naltrexone. Here is a full list of the side effects:

  • Headaches
  • Joint or muscle pain
  • Mild abdominal pain
  • Nausea
  • Tiredness
  • Trouble sleeping

It’s worth adding that not everyone who takes naltrexone will experience these side effects. What’s more, they are relatively minor compared to the withdrawal symptoms involved with heroin detox.

And finally, these side effects tend to go away after your body grows accustomed to the medicine.

Does naltrexone interact with any other drugs or medication?

Naltrexone will react with certain drugs, both legal and illegal. Here is a list of the drugs that may interact with naltrexone:

  • Disulfiram
  • Methadone
  • Opioids
  • Some medicines for coughs, diarrhoea and pain
  • Thioridazine

If you are getting naltrexone from inpatient rehab for heroin addiction, the rehab staff will know about this. They will make sure to check whether you are taking any other medication that could react with naltrexone.

How effective is naltrexone?

Although naltrexone is a relatively new drug, several studies have shown its efficacy.

One such study found that ‘patients receiving naltrexone had on average 45 days less heroin use and 60 days less opioid use than controls in the 180-day period’.

However, this study did have a small sample size. [2] Another study came to similar conclusions.

It, too, had a small sample size, with only 13 participants. [3] This may point towards one difficulty with testing medication like this. It is hard to find heroin users willing to participate in such a study.

Final thoughts

In this page, we’ve gone over some main points about naltrexone for heroin addiction.

We believe this is one of the better forms of medication available for helping people through withdrawal. It’s not perfect, but it does some wonderful things, such as blocking highs and reducing cravings.

Ultimately, naltrexone needs to be taken alongside all the normal parts of rehab. You need to get good rehab therapy, whether that’s CBT, DBT, or group therapy. 12-step programmes, counselling and holistic therapy all have a part to play, too.

We hope you enjoyed reading this, and that you are now better equipped to make the right decision for yourself or a loved one.

Frequently Asked Questions

Is there a risk of overdose after naltrexone treatment?

Yes, there is a risk of overdose once the implant is removed. This is one of the hidden dangers of naltrexone.

The reason why there is a risk of overdose is that the person in recovery has a much lower tolerance after a few months of using naltrexone. If they relapse after the implant has been removed, they might take more heroin than their body can process. This could lead to death.

This risk, though serious, has to be balanced against the good that naltrexone can do. Once again, naltrexone reduces cravings and blocks the high from opioids. This combination of effects is very helpful for aiding sobriety.

The only real solution is for patients to be told about the risks of overdose when they come off naltrexone. If they could be monitored during this period, for example in a sober living house or by a family member, that might also help to lessen the risk of overdose.

How long should you take naltrexone for?

With an implant, which we believe is the best way to take naltrexone, it lasts for 2 to 4 months. It may be worth taking naltrexone for even longer than that if you find that it helps. S

ome clinics recommend taking it for up to a year. Given that the first year is when your brain heals from addiction, and also when you are most at risk of relapse, this does make sense.

References

[1] https://www.recoveryanswers.org/research-post/naltrexone-implant-versus-daily-pill/

[2] https://pubmed.ncbi.nlm.nih.gov/19478295/

[3] https://www.karger.com/Article/Abstract/92115