Naltrexone (Vivitrol): What It Is, Addiction, And Abuse

Last Updated: July 5, 2021

Authored by Olivier George, Ph.D.

Reviewed by Michael Espelin APRN

Naltrexone is a medication designed to treat drug addiction and alcohol dependence. Sold under brand names such as Vivitrol and Revia, it is also used off-label in the treatment of many different conditions. However, many who use it do not understand what naltrexone is. Here is what they should know.

What Is Naltrexone?

The medication is most commonly used to help in the management of addiction. Specifically, addiction to opiates and alcohol. Other naltrexone uses range from treating pain disorders to helping manage the symptoms of Parkinson’s disease.

Sold under the brand name Vivitrol, among others, it comes in different formulations. The drug can be delivered by injection, through an implant, or by taking pills. While pills are most often used in low-dose naltrexone (LDN) therapy, they can be used in the treatment of any condition that benefits from the drug.

Naltrexone Prescription

A prescription for this medication is needed to acquire it legally. However, a prescription is pretty easy to obtain. The user just needs to have a condition that the drug is used to treat.

Any doctor or nurse with the correct privileges is someone who can prescribe naltrexone.

Someone who wants Vivitrol for opiate addiction should speak with someone who specializes in the treatment of that specific type of addiction and can get treatment started in a supervised setting. Naltrexone for alcoholism treatment should be done by a doctor who understands how to handle alcohol detox symptoms. A person trying to treat nerve pain should work with a neurologist. Ultimately, the idea is to find the right doctor for the condition rather than just doctors nearby who can prescribe the drug.

Naltrexone Drug Class

Like all medications, Vivitrol and LDN belong to a specific drug class. This drug class is determined by how the medication functions. Vivitrol’s drug class determines a lot about it, from what it can treat to how easy it is to access.

Is Naltrexone A Narcotic?

Narcotic is a term that, as defined by the Drug Enforcement Administration, refers to opium, any medication derived from opium, and any medication synthesized to mimic the effects of opium. Vivitrol is not a narcotic because it is not derived from opium. It also does not cause naltrexone high.

Is Naltrexone A Controlled Substance?

A controlled substance is anything that is known to be addictive, whether it has demonstrable therapeutic benefits or not. Vivitrol is not a controlled substance because it has never been shown in clinical trials to be addictive.

However, this definition of the term is based on how the DEA uses it. The general population may consider it to be a controlled substance because people cannot get naltrexone over the counter. However, while this may raise the Vivitrol cost, it does not make it an official controlled substance. The Vivitrol drug requires a prescription, but beyond that is not restricted.

Naltrexone Schedule

The drug schedule is used to classify controlled substances based on their potential for abuse weighed against their therapeutic benefits. Dependence and addiction are not amongst the naltrexone side effects. Because it is not addictive, and therefore not a controlled substance, there is no schedule classification for this drug.

naltrexone drug class

Is Naltrexone An Opiate?

An opiate is any medication that interacts with the opioid receptors in the brain to induce morphine-like effects. Vivitrol does interact with the body’s opioid receptors, but it does not cause the effects needed to be classed as an opiate. Therefore, Vivitrol is not an opiate.

Is Naltrexone An Opiate Antagonist?

Vivitrol interacts with the opioid receptors by occupying them and preventing other substances from interacting with them. This means that the correct drug class for naltrexone is an opioid antagonist. This is what the medication benefits come from. When taken, it prevents addictive substances from getting the user high, making naltrexone for alcohol dependence treatment a great solution.

Naltrexone Brand Names

Naltrexone is the generic name for naltrexone hydrochloride. The most well-known brand name is Vivitrol. However, other brand names include Revia and Depade. There are also numerous generic drug options available.

The only Vivitrol provider is Alkermes. Barr laboratories make Revia medication, while Mallinckrodt Pharmaceuticals makes Depade. Apotex, Aidarex, Pd Rx Pharmaceuticals, and AvKare are just a few of the manufacturers making generic versions of the drug.

Naltrexone Ingredients

What is in naltrexone will vary between manufacturers and methods of ingestion. It is made of both active and inactive ingredients. In all formulations of the drug that are not combination medicines, naltrexone HCL is the only active ingredient. The variations in ingredients come from inactive ones.

While different manufacturers can opt for different inactive ingredients, they tend to be mostly the same. The common inactive ingredients in Vivitrol pills are:

  • Crospovidone
  • Hypromellose, unspecified
  • Lactose monohydrate
  • Magnesium stearate
  • Microcrystalline cellulose
  • Polyethylene glycol, unspecified
  • Polysorbate 80
  • Silicon dioxide
  • Titanium dioxide
  • Ferric oxide yellow
  • Ferric oxide red

In comparison, Vivitrol injections tend to have the following inactive ingredients:

  • Polylactide-co-glycolide
  • Carboxymethylcellulose sodium salt
  • Polysorbate 20
  • Sodium chloride
  • Water

Naltrexone Abuse Potential

The abuse potential of the drug is considered to be nonexistent. Because medication does not produce any euphoric effects to drive addiction and cannot be altered or taken in a way that causes them, there isn’t a drive for users to abuse the medication. However, that does not mean that people will not try to abuse it or misuse it by taking it with other substances. In case of abuse, it is critical to find addiction treatment as soon as possible.

Is Naltrexone Addictive?

When used on its own, this drug is not addictive. However, there is a concern that if it is used with other medications, such as methadone and Wellbutrin, an addiction to the combination could form. Additionally, users might think Vivitrol is addictive because they feel a mental dependence on the drug. This tends to be more driven by fear of relapsing than a genuine naltrexone addiction.

Naltrexone Withdrawal And Stopping

This medication is one that is not thought to develop any form of physical dependence. As such, there is no such thing as naltrexone withdrawal.

Additionally, how the medication should be stopped depends on the motivation for doing so. If the user is trying to decide between naloxone vs naltrexone, they need to speak with an addiction specialist. If their concern is naltrexone and weight loss, help from a dietician might make the medication work. Ultimately, help is needed.

Getting Help

Whether someone is looking to get started with Vivitrol treatment or wants to stop it, medical supervision is required. Addiction rehab centers are often the best place to get help. There, they can determine the best course of action in an environment that is safe and supportive.

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Published on: June 7th, 2019

Updated on: July 5th, 2021

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.