Written by Elevated Healing Clinical Team · Medically reviewed by Dr. Taff
Quick Answer
Naltrexone — including its extended-release injectable form, Vivitrol — is an FDA-approved medication used in treating both opioid and alcohol use disorders. It is not an opioid and is not addictive; it works by blocking opioid effects and reducing cravings. This piece explains how naltrexone and Vivitrol work, who they can help, and how they fit into comprehensive recovery.
Naltrexone is an FDA-approved medication used in the treatment of both opioid use disorder and alcohol use disorder. It comes in more than one form: a daily oral tablet, and an extended-release injectable form known by the brand name Vivitrol, given roughly monthly. Vivitrol is, in essence, a long-acting version of naltrexone — the same medication, delivered so it lasts about a month per injection.
An important point up front: naltrexone is not an opioid, is not a controlled substance, and is not addictive. This distinguishes it from some other medications used in treatment and makes it a useful option for many people. This piece explains how naltrexone and Vivitrol work, who they can help, and how they fit into comprehensive recovery — accurately and without overstatement.
Naltrexone works as an opioid antagonist, meaning it binds to opioid receptors in the brain and blocks them. For opioid use disorder, this means that if a person uses an opioid while on naltrexone, the opioid’s effects are blocked — removing the reward and helping break the cycle of use. It does not produce a high or create dependence itself; it simply blocks the receptors.
For alcohol use disorder, naltrexone works somewhat differently, thought to reduce the rewarding effects of alcohol and help diminish cravings, which can support a person in drinking less or maintaining abstinence. In both cases, the medication addresses the physiology of addiction — blocking reward or reducing craving — to make the behavioral work of recovery more achievable. It does not do the work of recovery by itself.
There is an essential safety point for opioid use disorder: because naltrexone blocks opioid receptors, a person must be fully detoxed and opioid-free for a period before starting it. Starting naltrexone while opioids are still in the system can precipitate sudden, severe withdrawal. This is why naltrexone for opioids comes after a person has completed withdrawal, often following a supervised detox.
This requirement is a key difference from some other opioid medications and shapes when naltrexone fits in the treatment pathway. A qualified provider determines the appropriate timing to start it safely. There is also an important consideration after stopping naltrexone: because the receptors are no longer blocked and tolerance has dropped, the risk of overdose is elevated if a person returns to opioid use — which a provider will discuss as part of safety planning.
Naltrexone is a particularly clear counter to the persistent myth that medication-assisted treatment just ‘replaces one drug with another.’ Naltrexone is not an opioid, produces no high, causes no dependence, and is not a controlled substance — it is, in fact, a blocker rather than a substitute. Whatever one makes of that myth in general, it plainly does not apply to a medication that blocks opioid effects rather than providing them.
This makes naltrexone an option that appeals to people who specifically want a non-opioid, non-addictive approach. It is worth understanding accurately rather than dismissing under a misconception that does not fit it. Like all of these medications, naltrexone is legitimate medical treatment — and in its case, the ‘replacing drugs’ concern simply has no basis.
Naltrexone, in either form, can help people with opioid use disorder (once fully detoxed) or alcohol use disorder, as one component of treatment. The extended-release Vivitrol form can be especially useful for people who find a monthly injection easier to maintain than a daily pill, removing the need to decide to take medication each day. The choice between forms, and whether naltrexone fits at all, is individual.
Whether naltrexone is right for a given person depends on their substance, history, medical factors, and situation, decided with a qualified provider. It is not the only option, and for opioid use disorder in particular, other medications work differently and may suit some people better. It is most established for opioid and alcohol use disorders; for stimulants, there is no comparable approved medication. The point is that naltrexone is a valuable option worth understanding and discussing.
As with all medication-assisted treatment, naltrexone and Vivitrol are not standalone solutions but components of comprehensive care. The medication addresses physiology — blocking opioid effects or reducing alcohol cravings — but lasting recovery still requires the behavioral work: therapy to understand and change patterns, support to sustain it, and attention to life factors and any co-occurring conditions. Naltrexone makes that work more achievable; it does not replace it.
This is why naltrexone is delivered within a broader plan. For people who also have a mental health condition, that plan coordinates both — a clear primary track with the other condition addressed in step, rather than one merged program that can dilute focused care. You can read how that coordination works on our specialty-led care page.
Opioid and alcohol use disorders frequently coexist with mental health conditions, and naltrexone’s role sits within that fuller picture. Treating the substance use with medication while leaving an underlying depression, anxiety, or trauma unaddressed tends to fall short, because the drivers of use remain.
A misconception worth naming is that co-occurring care requires one merged program treating everything at once; in practice, collapsing distinct conditions together can dilute the focused care each needs. The specialty-led approach keeps a clear primary track and addresses the other condition in step, coordinated under one team, with any role for naltrexone fitting into that coordinated plan. You can read more on our programs page.
If you or someone you love is facing opioid or alcohol use disorder, naltrexone — whether as a daily tablet or the monthly Vivitrol injection — may be worth asking about, particularly if a non-opioid, non-addictive option appeals to you. The way to find out whether it fits is a clinical evaluation that considers your specific situation and the right timing.
A free, confidential assessment can clarify whether naltrexone has a role in your care and how it would fit a broader plan, including any necessary detox first. You are welcome to explore our programs or contact our team. If you or someone you know is ever in immediate danger, call 911; for crisis support any time, call or text 988.
Reach our admissions team for a free, confidential assessment — in Woodland Hills or by phone across California.
Get a Free AssessmentNaltrexone is an FDA-approved medication used in treating both opioid use disorder and alcohol use disorder. It comes as a daily oral tablet and as an extended-release injectable known by the brand name Vivitrol, given roughly monthly — essentially a long-acting version of the same medication. Importantly, naltrexone is not an opioid, not a controlled substance, and not addictive, which distinguishes it from some other treatment medications. It works by blocking opioid receptors and reducing cravings, addressing the physiology of addiction to make the behavioral work of recovery more achievable. It is one component of comprehensive treatment, not a standalone fix.
Naltrexone is an opioid antagonist — it binds to and blocks opioid receptors in the brain. For opioid use disorder, this means that if a person uses an opioid while on naltrexone, the opioid’s effects are blocked, removing the reward and helping break the cycle of use; it produces no high and creates no dependence. For alcohol use disorder, it is thought to reduce the rewarding effects of alcohol and diminish cravings, supporting reduced drinking or abstinence. In both cases it addresses the physiology of addiction to make the behavioral work of recovery more achievable, rather than doing that work itself.
Because naltrexone blocks opioid receptors, a person must be fully detoxed and opioid-free for a period before starting it for opioid use disorder. Starting it while opioids are still in the system can precipitate sudden, severe withdrawal. This is why naltrexone for opioids comes after a person has completed withdrawal, often following a supervised detox, with a qualified provider determining the safe timing. There is also an important consideration after stopping: because receptors are no longer blocked and tolerance has dropped, overdose risk is elevated if a person returns to opioid use, which a provider discusses as part of safety planning.
No — naltrexone is a particularly clear counter to that myth. It is not an opioid, produces no high, causes no dependence, and is not a controlled substance; it is a blocker rather than a substitute. Whatever one makes of the ‘replacing drugs’ concern in general, it plainly does not apply to a medication that blocks opioid effects rather than providing them. This makes naltrexone appealing to people who specifically want a non-opioid, non-addictive approach. Like all these medications, it is legitimate medical treatment, and in its case the ‘replacing drugs’ concern simply has no basis.
Naltrexone, in either form, can help people with opioid use disorder (once fully detoxed) or alcohol use disorder, as one component of treatment. The extended-release Vivitrol form can be especially useful for people who find a monthly injection easier to maintain than a daily pill. Whether naltrexone is right depends on the substance, history, medical factors, and situation, decided with a qualified provider. It is not the only option — for opioid use disorder, other medications work differently and may suit some people better — and it is most established for opioid and alcohol use disorders, with no comparable approved medication for stimulants.
No. Like all medication-assisted treatment, naltrexone and Vivitrol are components of comprehensive care, not standalone solutions. The medication addresses physiology — blocking opioid effects or reducing alcohol cravings — but lasting recovery still requires the behavioral work: therapy to understand and change patterns, support to sustain it, and attention to life factors and any co-occurring conditions. Naltrexone makes that work more achievable; it does not replace it. This is why it is delivered within a broader plan, and for people with a co-occurring mental health condition, that plan coordinates both through a clear primary track.
The way to find out is a clinical evaluation that considers your specific situation and the right timing. If you or someone you love is facing opioid or alcohol use disorder, naltrexone — as a daily tablet or the monthly Vivitrol injection — may be worth asking about, particularly if a non-opioid, non-addictive option appeals to you. A free, confidential assessment can clarify whether it has a role in your care and how it would fit a broader plan, including any necessary detox first. If you or someone you know is in immediate danger, call 911, or call or text 988.
Medically reviewed by Dr. Taff
Clinical review for accuracy and compliance.
Fill out the form below and we'll get back to you within 24 hours.
We've received your request and will be in touch within 24 hours.
