Naltrexone was first approved for medical use in the mid 1980s, so it’s not a new drug. Naltrexone is a “competitive opioid antagonist”, meaning it blocks opioid receptors in the brain and body. This could be overcome by a very large amount of opioid, which is why patient safety through team assessments is key. In the UK, oral naltrexone is licensed for relapse prevention in opioid-dependent or alcohol-dependent patients. One of the hardest challenges is to remain addiction-free long term. With opioids, UK services often switch a ‘bad’ opioid like heroin for a ‘better’ one like methadone or buprenorphine (Subutex), with potentially low yearly success rates at being opioid free. In general, in the UK, naltrexone is almost exclusively taken daily in tablet form, if prescribed at all. With the oral form of naltrexone, there may be temptation to stop taking it and go back to opioids whilst long-acting naltrexone can last weeks or months at a time.
How does it work?
Opioid receptors play a role in the reward system in the brain, meaning that blocking them with naltrexone may reduce the pleasurable ‘high’ and can also reduce cravings in a range of addictions.
For alcohol, opioids, cocaine or other substances, we can consider naltrexone at an early stage following a comfortable detox*. Many detox programmes may run over several weeks before removing the primary drug addiction. A lot of patients may not be able to tolerate a lengthy withdrawal and the dropout and success rates may be highly variable. The BONDS protocol balances time and comfort in an individualised way to help you improve your chances of detoxing quickly, safely and effectively with real-world success rates (for previous implementation of the BONDS protocols at previous services).