Naltrexone is an alcohol withdrawal medication that helps reduce cravings and maintain recovery. It does not treat acute withdrawal symptoms. However, it plays an important role in long term relapse prevention.
In this article, you’ll learn how naltrexone works in the brain, when it is prescribed and what benefits it offers during alcohol use disorder treatment. We’ll also cover how it differs from other alcohol withdrawal medications and what to expect if you or a loved one begins treatment with naltrexone.
Key Facts
- Alcohol withdrawal happens within hours after stopping heavy use, peaking at 24–72 hours and resolving in about a week.
- Naltrexone does not address acute withdrawal but supports recovery after detox.
- This medication blocks opioid receptors to reduce cravings and relapse risk.
- Safe use requires being opioid free, having stable liver function and completing detox.
- Oral (daily pill) and injectable (monthly shot) forms allow flexible treatment planning.
- Benzodiazepines and phenobarbital, not naltrexone, treat the acute withdrawal phase.
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The Role Naltrexone Plays in Alcohol Withdrawal
Naltrexone plays an important role in alcohol use disorder treatment, but not in the way you may assume. The main purpose is to support long term recovery by lowering cravings and reducing the risk of relapse.
Alcohol Withdrawal 101
Alcohol withdrawal happens when your body reacts to the sudden absence of alcohol after heavy or prolonged use. Symptoms of withdrawal usually begin within 6 to 24 hours, peaking around 24 to 72 hours and resolving within 3 to 7 days.
Symptoms may range from mild anxiety and tremors to more severe complications like seizures or delirium tremens (DTs).
Certain warning signs require urgent medical attention. These red flags include confusion, hallucinations, high fever, uncontrolled vomiting and severe tremors. If any of these occur, immediate medical care is critical for your safety.
Why Naltrexone Isn’t for Acute Withdrawal & Where It Fits After Detox
Naltrexone does not manage the immediate dangers of alcohol withdrawal. These include autonomic hyperactivity, seizures or other acute symptoms. These are commonly treated with medications like benzodiazepines or phenobarbital under medical supervision.
Using naltrexone in the early stage of alcohol withdrawal does not provide the necessary protection against serious risks. However, naltrexone plays a crucial role after detox, when the focus shifts from short term stabilization to long term recovery.
Naltrexone helps reduce cravings, lowers the number of heavy drinking days and supports ongoing sobriety. This makes it a valuable tool in relapse prevention and sustained recovery in alcohol use disorder treatment.
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How Naltrexone Works and When to Start
Naltrexone is an important medication, but timing is key to its effectiveness. It should be introduced after detox, once your body is clear of alcohol and withdrawal symptoms have resolved.
Mechanism & Expected Benefits
Naltrexone works as a mu opioid receptor antagonist. They block your brain’s reward pathways that are normally activated by alcohol. By reducing the pleasurable effects of drinking, it helps weaken the urge to drink in response to triggers or environmental cues.
The benefits of this approach include fewer heavy drinking days, longer periods before relapse and improved outcomes when combined with counseling or structured therapy. Together, these effects make naltrexone a valuable tool in your long term recovery.
When to Start Naltrexone After Detox and Pre-Start Checklist
Beginning naltrexone too early can be unsafe and may interfere with proper recovery from the acute withdrawal phase.
Several criteria must be considered before beginning naltrexone, including:
- Alcohol withdrawal symptoms are fully resolved
- Confirmed opioid free to avoid severe withdrawal
- Thorough review of current medications and allergies
- Baseline liver function tests
- Comprehensive education to ensure safe and effective use
Options, Dosing and Choosing the Right Formulation
Naltrexone is available in oral and injectable forms. This allows you and your providers flexibility in customizing your treatment plan.
The appropriate option depends on factors like lifestyle, adherence and medical history. This highlights the need to consider common dosing approaches and key considerations to select the most effective formulation.
Oral Naltrexone (Typically 50 mg Daily)
Oral naltrexone is most often prescribed at 50 mg per day. However, administration can begin with a 25 mg test dose before titrating up. Taking naltrexone with food can help reduce gastrointestinal discomfort.
This option is well suited as a first line trial since it is easy to start, stop or adjust the dosage as needed. However, it is critical that you consistently adhere to treatment since missed doses can limit the effectiveness and reduce the medication’s ability to curb cravings.
Extended Release Naltrexone (380 mg IM Monthly)
Extended release naltrexone is given as a 380 mg intramuscular injection once a month. This is a convenient alternative when you struggle with daily pill taking or prefer a long acting option. This formulation helps ensure steady medication levels and consistent support against cravings.
Before beginning treatment, your provider takes several precautions to reduce complications and make treatment more effective. These steps include:
- Screening for potential injection site concerns
- Confirming you are opioid free for an adequate period
- Reviewing full medical history
- Checking baseline liver function
- Education on what to expect during treatment
Choosing Oral vs. Injection
Deciding between oral and injectable naltrexone depends on several factors. These include adherence, access to care, insurance coverage, side effect tolerance and personal preference. The best choice varies by individual needs.
It’s important to consider logistics such as the ability to attend monthly clinic visits for injections. As well you should have plans for managing missed doses and whether transitioning between formulations might be helpful over time. A collaborative discussion with a provider ensures the most practical and effective approach.
Safety and Special Situations
Naltrexone is generally safe and well tolerated. However, certain health conditions and circumstances require extra caution. This section outlines key safety considerations and special situations where careful monitoring or alternative approaches may be needed.
Liver Safety & Monitoring
Naltrexone should not be used if you have acute hepatitis or liver failure. Baseline liver function tests (LFTs) are recommended before starting treatment. Periodic monitoring helps ensure continued safety during use.
Providers carefully weigh the risks and benefits when you have mild to moderate enzyme elevations. They educate you about the warning signs of hepatitis, such as jaundice, dark urine or abdominal pain. This proactive approach supports both safety and effective treatment.
Opioid Free Status & Pain Management Planning
Before starting naltrexone, individuals must be completely opioid free to avoid precipitated withdrawal. Once on treatment, the medication blocks opioid receptors, making opioid based pain relief ineffective.
For surgeries or procedures, advanced planning is essential. Non opioid pain management strategies should be prioritized. If opioids are absolutely required, coordination with specialists helps ensure safe and effective care.
What Treats Alcohol Withdrawal
Alcohol withdrawal requires medications that directly calm the nervous system and prevent dangerous complications as the body detoxifies. These are first line medications that work differently from naltrexone, but are critical to recovery.
First Line Medications & When Inpatient Care Is Needed
The mainstay of alcohol withdrawal treatment is benzodiazepines, given either on a symptom triggered schedule or as fixed doses. A customized treatment plan based on evidence based measurement tools helps providers make accurate decisions about how medications are administered.
In some experienced settings, phenobarbital may be added for additional control. Supportive care is equally important. This includes thiamine before glucose, fluids and electrolytes and close monitoring of vital signs.
Inpatient care becomes necessary when there is a high risk of severe alcohol withdrawal symptoms.
Admission is recommended when there is a history of:
- Severe withdrawal
- Seizures
- Delirium tremens
- Unstable vital signs
- Pregnancy
- Limited support at home
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Naltrexone Frequently Asked Questions
No, naltrexone does not manage tremors, agitation, blood pressure spikes or seizures.
These symptoms require evidence based withdrawal protocols, often with benzodiazepines or phenobarbital. Naltrexone is introduced after detox and stabilization to support long term recovery and reduce cravings.
Naltrexone is usually started once acute withdrawal symptoms are resolved. This commonly occurs between 3 to 7 days of abstinence.
Before beginning, your provider confirms you are opioid free and have acceptable liver function tests. Follow up visits help monitor your response and ensure the medication is well tolerated.
Always inform your care team that you’re taking naltrexone. For elective procedures, planning is essential.
Non opioid pain control is preferred. However, if opioids are necessary, they must be managed carefully by specialists. Naltrexone can be safely restarted once opioids are no longer required.
Find Treatment Near You
Finding the right treatment program for alcohol withdrawal is crucial to your long term success. Naltrexone plays a unique role in supporting sustainable recovery.
Use the treatment directory at Rehab.com to search for centers that match your needs. You can filter by location, level of care, accepted insurance and special programs to find the right fit.
Not sure where to start? Call today
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to talk with someone about available treatment options and learn whether your insurance covers alcohol rehab.
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Top Rated Centers for Alcohol Addiction Treatment
| Name / Address / Rating | Description | Treatments / Payments / Programs | Review / Contact | Images | |
|---|---|---|---|---|---|
Boca Recovery Center – Bloomington Alcohol & Drug RehabAd This is an ad and Boca Recovery Center – Bloomington Alcohol & Drug Rehab is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Bloomington, IN | The Boca Recovery Center is a luxury alcohol and drug rehab center for adults in Bloomington, Indiana. They specialize in cutting edge addiction treatment provided in a residential setting. Boca Recovery Center Bloomington is a luxury addiction treatment center in Bloomington, Indiana, offering medical detox, residential treatment, and partial hosp | Treatments Programs Payment Options  Drug Addiction Alcoholism Opioid Addiction Dual Diagnosis Mental Health and Substance Abuse Substance Abuse  Adult Program Young Adult Program Seniors Program LGBTQ Program Military Program  Private Insurance Self-Pay Options Military Insurance Financial Aid | View Website (930) 203-1400 | 
Friendly and caring staff
sherry tice
2 weeks ago
I stumbled (literally) into BOCA Recovery center on February 5th with little hope. I was set to spend 21 days away from all the comforts of Home My family and dog.
My first week of detox was more comfortable than I expected. Assisted with medications that helped me through The Tough days ahead. After I came out of the fog I dove head first into my recovery.
I went to every group meeting. I went to every AA meeting available I participated 100% And was determined to take advantage of every tool I would need to be successful. I learned Skills from so many People that have been there done that
And could relate to what I was feeling honestly feeling.
I didn’t realize I had so many traumas until we started talking about it. I have an addictive personality And the roots run deep through my family tree. With all the professional help I was able to navigate through those tough Traumas.
I realized I was drinking to bury those feelings and forget. They run a tight Shift With an Excellent routine.
They fed us very well.
They really focused on mind-body and soul. I will be forever grateful for the help
That I receive the true caring I received.
The understanding I received. And just knowing I was not alone. I met some very cool people who were in the same boat as I
Just rowing with different paddles.
I surrounded myself with positive people who were serious about their rehabilitation.
Today I am 26 days sober. I have never felt better mentally physically and spiritually.
There is no better high from a drink or a drug that I’m experiencing on a sober life.
For the first time in four years, I am present
And excited for the future. Thank you to everyone at Boca recovery you guys are amazing people I would recommend BOCA
TO ANYONE WHO IS STRUGGLING!!
Thank you for giving me a second chance at life! And I wanna thank me for taking that first step and making that phone call!
Peace and Love, Barbara
Barb Mosqueda
4 weeks ago
Incredible place to find yourself, great sense of community. The entire staff truly cares about the well being of clients
Isaiah
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8.90 / 10 | Soberman’s Estate, located in Cave Creek, Arizona, is an alcohol and drug rehab center that provides addiction treatment services to adult men, professionals, and public figures. They are a discrete, luxury rehab for individuals aged 30 to 80 years old. This location caps their treatment center at ten men at a time. As one of leading inpatient re | Treatments Programs Payment Options Mental HealthSubstance AbuseAlcoholismOpioid AddictionMental Health And Substance Abuse Adult ProgramYoung Adult Program Program For Men Private InsuranceSelf-Pay OptionsFinancial Aid Sliding Scale Payment Assistance Medicaid Medicare | 
Soberman’s Estate was everything I needed for my recovery. The staff, the program, physical activity and culinary experience were top notch and essential. The program is well designed and worked better than I expected. The staff is remarkable – professional, considerate and genuinely caring. My time there and being removed from alcohol for five weeks was everything I needed to remove my craving for alcohol. Soberman has changed my life in ways I never could have imagined. I feel confident, secure and grateful for my new life. I have reconnected with my family and friends. Thank you Soberman.
George B.
5 months ago
Yes, very professional staff, treatment, therapist, chefs were good! even the home cook did the best she could, and loved the horses of Course! Saturday morning hiking was fun to explore the trails of the nearby mountain area!
John E Williams
5 months ago
I had a great experience overall and would recommend it to anyone wanted to jump start their sobriety!!
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8.81 / 10  Claimed | All In Solutions Detox in Simi Valley is one of the best ranked inpatient detox facilities in California providing safe, medically supervised care for individuals beginning their recovery from drug or alcohol addiction. As part of the All In Solutions Behavioral Health network, this facility serves as the first step in a full continuum of care. Cli | Treatments Programs Payment Options AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis Adult ProgramYoung Adult ProgramProgram For Men Program For Women Private InsuranceSelf-Pay Options | 
This facility is awesome. The staff is so caring about everyone. I would definitely recommend All in solutions.
Deanna Flores
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Amazing place they helped me get my faith back and I really enjoyed the groups. It was honestly the best treatment I have been to and I have been to guide quite a few. Thank you so much
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8.80 / 10 | St. Christopher’s Addiction Wellness Center is an addiction rehabilitation facility in Baton Rouge, Louisiana. The center opened in 1998 with the vision of offering affordable addiction treatment. They have a residential treatment program for men along with outpatient treatment services available to men and women. They view substance use disorder | Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay Options | 
St Christopher was a wonderful experience for me to get sober, learn about Alcoholics Anonymous, and learn about the disease and about myself. The staff from the front office down were fantastic, before, during, and after treatment. I would recommend this place to anyone
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I have been a professional interventionist since 2010. I was introduced to this program in 2012. I have been referring there since then. My clients have always had a positive experience and the clinical and support staff are the most responsive and knowledgeable. They want what’s best for the client and the family and have long term options. They do very well young adult males and most recently I referred a 69 year old man first time treatment. It was a family member and he’s doing very well and committed to 90 days of treatment. I can’t thank the clinical staff and administrators enough for the program they have created. Please contact me if you would like to know more. Thank you STC!!!
asher levine
9 months ago
This is my first time doing IOP and I luv it Mike Ramos is the best my family even luvs him good person great attitude he as a way of wanting to do right and stay right and you can tell he is genuine about his job unlike miss star he as a way of teaching addiction were you understand it always keep Mike and his little dog brisket he’s a big part of Saint Christopher’s
Cedric Banks
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Avenues Recovery Center at ClarksvilleAd This is an ad and Avenues Recovery Center at Clarksville is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Clarksville, IN Claimed | Avenues Recovery Center in Clarksville, Indiana, is an inpatient drug and alcohol detox and rehab center. They strive to provide individuals receiving treatment with a loving environment and attentive medical care. You’ll be away from toxic environments and triggers and have the opportunity to focus on developing life skills that will support you | Treatments Programs Payment Options AlcoholismMental Health And Substance AbuseDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsMedicaidMilitary Insurance | View Website (930) 203-1947 | 
This progame saved my life. The staff are great. They understand each and every one of use.
Shay D
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Avenues staff genuinely cares about each and every client. This place saved my life and help me start finding who I truly am.
Jessica Faye
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8.80 / 10 | Symetria – Hurst Outpatient Rehab and Suboxone Clinic in Hurst, Texas, is a private drug rehabilitation clinic for adults. One of the best outpatient rehab centers in Texas, Symetria offers various withdrawal medications to help clients get started with their recovery journey. You’ll also have access to treatments such as the intensive outp | Treatments Programs Payment Options Substance AbuseAlcoholismOpioid Addiction Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsMedicareMilitary Insurance | 
Symetria is unbelievably amazing!!! The Hurst staff is phenomenal!!! I can’t imagine that another location has a better staff. A special shout out to Deborah, Benjamin, and Samantha of course. You all are doing amazing, amazing, selfless work. You all are very special to so many!!!
Vernon Godsey III
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Huge shout out to the team at symetria who make me feel like family I appreciate everything they do and huge shout out to Osagie for helping me! He is AWESOME!!! I love you symetria❤️❤️❤️
Chloe Roseman
5 months ago
BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again!
Mason
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8.80 / 10 Claimed | Boca Recovery Center – Galloway is a drug and alcohol rehab in Galloway, NJ. They provide inpatient addiction treatment and medical detox. Boca Recovery Center Galloway is a 22-bed addiction treatment facility in Galloway, New Jersey, offering medically supervised detox, residential care, and outpatient programming in an upscale, evidence-based | Treatments Programs Payment Options Mental Health and Substance AbuseDrug AddictionAlcoholismOpioid AddictionDual DiagnosisSubstance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For WomenSeniors ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsMilitary InsuranceFinancial Aid | 
My experience was very professional and helpful! The detox and rehab experience has made an impact on my life and future, I am very grateful for the staff and my therapist Ashley was absolutely amazing. The time I spent here, they provided good attention to what has to be focused on.
Anna Mattina
1 month ago
Great facility, was absolutely the best move I could’ve made! Staff, nurses and chefs are top notch! Wanna start getting well, Boca jersey is the place to come and get help!
Meagan Stranninger
1 month ago
My sobriety journey started at Boca. The staff members including Miss Tracey, Hannah and Kevin their alumni coordinator have completely flipped the trajectory of my life. I was immediately taken in with open caring arms and they made my detox process as comfortable as possible. During my stay, Joe was extremely helpful in helping me slowly gain my appetite back and start to feel stronger and was so attentive to my nutritional health. Nurse Patrick was so kind to me during my intake and Kevin still reaches out to me very often to check in and is so helpful in my recovery process. I owe gaining my life, my strength and my family back to Boca and I am eternally grateful❤️
Rianna Dean
2 months ago
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Top 10 Rehab in FL
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now.
8.79 / 10 Claimed | All In Solutions Counseling Center is a mental health center and addiction treatment program in Boynton Beach, Florida. They provide a partial hospitalization program, an intensive outpatient program (IOP), an outpatient program, medication-assisted treatment, and mental health care for adults with substance use disorder. All In Solutions Counseli | Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Self-Pay OptionsPrivate insurance | 
Amazing place for recovery. The staff amd facilities are perfect!!!!
John Bollman
6 days ago
I had the most AMAZING spiritual experience at All In. The staff was very welcoming and kind. The therapist were EXCELLENT! I learned a lot of tools that will help in my sober journey.
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Amazing staff and overall treatment
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Top 10 Rehab in CA
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Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now.
8.77 / 10 Claimed | Rise in Malibu is a secluded drug and alcohol rehab program in Malibu, California. They deliver Joint Commission accredited detox, inpatient treatment, medication assisted treatment (MAT), and aftercare services to adult clients. Their campus boasts luxury amenities and a seaside view. Detoxification at Rise Malibu takes place in its luxury residen | Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance Abuse Adult ProgramYoung Adult Program Private InsuranceSelf-Pay Options | 
Rise really means a lot to me. I’ve been to the Malibu location twice, and both times the team made me feel genuinely cared for, supported, and understood during some of the hardest times in my life. Dr. Mark was awesome to work with, and I also want to thank Ron, Sherry, Nam, Tessa, Zack, and Ryan. You all made a bigger impact on me than you probably know. What makes Rise special is that it never just felt like treatment to me — it felt like family. I’ll always have love for the Malibu team and a lot of gratitude for everything they’ve done for me. Also give my compliments to the chefs
noah barclay
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I can’t say enough good things about Rise. They helped me when I was at my worst and it’s an extremely friendly and easy environment To rehabilitate. The people there are amazing, especially Ron And Allison, but I wouldn’t even limit to it to them. Everybody there is amazing. The rooms are comfortable and big. The food provided by professional chefs is amazing. Most of all the therapy were provided, saved my life!!
Tyler Shupe
3 weeks ago
Received wonderful care here. From the moment I entered the facility, I knew I was in good hands. Something obvious about Rise early on is the amount of care and interest the team has in you and your recovery. At every point of my journey, I was confident that the team had my best interests in mind. The location is gorgeous and comfortable. Every day I looked forward to the engaging group therapies, the kind and friendly conversations I enjoyed with staff, and the wonderful food prepared by the chefs. I highly recommend Rise if you find yourself in need
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1 month ago
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Top 10 Rehab in TN
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8.77 / 10 | If you’re looking for a Christian-based men’s drug rehab center, S2L Recovery in Woodbury, Tennessee, might be the place for you or your loved one. Located at the top of Short Mountain, and overlooking the green hills of Middle Tennessee, this residential and detox clinic boasts a one-to-one staff/patient ratio so there’ll always be someone t | Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual Diagnosis Adult ProgramYoung Adult ProgramProgram For Men Private InsuranceSelf-Pay Options | 
Coming from Canada, I was hesitant. But God knew that S2L was exactly where I needed to be. At 64 years of age, I was able to discover my true identity, purpose, and mission in Christ. They help you in trying to get clean and sober for sure. But what S2L and the staff are all about is the Gospel of Jesus Christ. That’s why it is so successful.
TIM TANNER
5 months ago
I’ve had the privilege of seeing the life-changing impact this ministry has on countless men & I can’t recommend it highly enough! God has His Hand on this ministry & I’m honored to see the Lord work in these men!
Hunter Stanfield
5 months ago
Come here with a open mind and heart. It can and WILL change your life in all ways. Trust the process and trust God! Could go on and on about how amazing this place, I’ll forever be grateful!
Trevor Woodard
5 months ago
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