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The End of my Addiction

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Naltrexone is one of three medications approved for use of Alcohol Use Disorders in the US, Canada and Europe. The injection form, Vivitrol, has been approved in the US but not yet in Canada or Europe. 

It is an opioid receptor antagonist. It is not addictive and has few side effects. It is no longer patented. 

There are three methods for taking naltrexone. The Sinclair Method, also known as the "as needed" method. Daily dosage, which is how it is most commonly prescribed. And the most recent application, a once monthly injection, called Vivitrol. These are discussed individually in the sections below. 

"Naltrexone has been researched for more than 20 years. Not only do the studies show proven efficacy for the medication, they offer clues as to who might have the most success using it. Research shows that people with the following traits are more likely to respond favorably:

  • male 
  • strong sweet-liking
  • high craving
  • those highly susceptible to alcohol-cue triggers
  • those motivated by the pleasure and the high of alcohol, rather than those who are trying to escape from anxiety and depression
  • early-onset alcoholics
  • those with a strong family history of alcoholism
  • those with certain gene variations

There is some anecdotal evidence that those who feel an immediate initial response to naltrexone are more likely to be strong responders.

There are exceptions to the above qualifications and positive results are certainly not limited to the list above."1

In a 2015 study published in JAMA Psychiatry, Dr. David Oslin wrote, "Some patients are very strong responders to naltrexone, and other patients don't seem to benefit whatsoever. And unfortunately, we don't have a way of predicting that still, right now. This study doesn't take away from naltrexone as a treatment option, we just can't personalize it yet."2 

"By 2001 there had already been 14 trials assessing the effectiveness of naltrexone compare with placebo for treating alcoholism, enrolling 2127 subjects, in 5 countries."3 

A 2002 report stated, "there is strong evidence that naltrexone significantly reduces alcohol relapses to heavy drinking, the frequency and quantity of alcohol consumption in those who do drink, and alcohol craving"4

Interestingly, in a review of 64 trials from 1970 to 2009, "Acamprosate had a significantly larger effect size than naltrexone on the maintenance of abstinence, and naltrexone had a larger effect size than acamprosate on the reduction of heavy drinking and craving."5

1. Burlison, Linda (2016-02-02). A Prescription for Alcoholics - Medications for Alcoholism (Kindle Locations 6733-6757. Pages 341-343). Stonecutter Books. Kindle Edition. 

2. Oslin DW, Leong SH, Lynch KG, et al. Naltrexone vs Placebo for the Treatment of Alcohol Dependence: A Randomized Clinical Trial. JAMA psychiatry. 2015;72( 5): 10-11. doi: 10.1001/ jamapsychiatry. 2014.3053.

3. Burlison, Linda (2016-02-02). A Prescription for Alcoholics - Medications for Alcoholism (Kindle Locations 6866. Page 350). Stonecutter Books. Kindle Edition. 

4. Leavitt SB. Evidence for the Efficacy of Naltrexone in the Treatment of Alcohol Dependence (Alcoholism). Addict Treat Forum. 2002.

5. Maisel NC, Blodgett JC, Wilbourne PL, Humphreys K, Finney JW. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: When are these medications most helpful? Addiction. 2013;108( 2): 275-293. doi: 10.1111/ j. 1360-0443.2012.04054. x.

 

 

 

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