Can't Stop the Urge? Why Naltrexone Works & Medically Approved Steps

If you feel like you can't stop the urge to drink or use opioids—even when you truly want to—it's not a failure of willpower. Persistent cravings are often rooted in brain chemistry. One medication that directly targets those cravings is naltrexone.

Naltrexone is FDA-approved and widely used to treat alcohol use disorder (AUD) and opioid use disorder (OUD). When prescribed and monitored by a doctor, it can reduce cravings, lower relapse risk, and help people regain control.

Below, we'll explain how naltrexone works, who it's for, what to expect, and medically approved steps to move forward.

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Why Do Cravings Feel So Powerful?

Alcohol and opioids stimulate the brain's reward system. They trigger the release of endorphins and dopamine—chemicals that create feelings of pleasure and relief.

Over time:

• The brain begins to rely on the substance for reward.
• Natural pleasure responses become weaker.
• Cravings grow stronger.
• Stopping suddenly may lead to withdrawal symptoms (especially with alcohol or opioids).

This isn't about being "weak." It's about changes in brain signaling. That's where naltrexone comes in.

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What Is Naltrexone?

Naltrexone is a medication that blocks opioid receptors in the brain. These receptors are involved in the "reward" effects of alcohol and opioids.

It is approved for:

• Alcohol use disorder (AUD)
• Opioid use disorder (OUD) (after detoxification)

It comes in two forms:

• Oral tablet (usually taken daily)
• Extended-release injection (given once monthly by a healthcare professional)

Both forms are effective. The best option depends on your medical history, preferences, and ability to take medication consistently.

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How Naltrexone Works

Unlike some medications, naltrexone does not make you sick if you drink. Instead, it works by:

• Blocking the pleasurable effects of alcohol or opioids
• Reducing the "reward" sensation
• Decreasing cravings over time
• Lowering the risk of relapse

Many people report that when they drink while taking naltrexone, it feels less rewarding. Over time, the brain learns that alcohol no longer delivers the same payoff.

This process can help break the cycle of craving and compulsive use.

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What the Research Shows

Clinical studies consistently show that naltrexone:

• Reduces heavy drinking days
• Lowers total alcohol consumption
• Decreases relapse rates in opioid recovery
• Improves long-term recovery outcomes when combined with counseling

It is considered a first-line treatment by major medical organizations for alcohol use disorder.

However, medication works best as part of a broader plan—not as a standalone solution.

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Who Is a Good Candidate for Naltrexone?

You may benefit from naltrexone if:

• You experience strong alcohol cravings
• You want to reduce drinking or stop entirely
• You have completed opioid detox and want relapse prevention
• You struggle with repeated relapse despite trying to quit

You may not be a candidate if:

• You are currently using opioids (naltrexone can trigger withdrawal)
• You have acute hepatitis or severe liver failure
• You are allergic to the medication

Because naltrexone affects liver enzymes, your doctor will usually order blood tests before starting treatment.

If you're experiencing persistent urges and want to better understand what might be driving them, try Ubie's free AI symptom checker to identify patterns in your symptoms and prepare informed questions before your doctor visit.

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What to Expect When Taking Naltrexone

Common Side Effects

Most people tolerate naltrexone well. Possible side effects include:

• Nausea
• Headache
• Fatigue
• Dizziness
• Mild anxiety
• Trouble sleeping

These symptoms are often temporary and improve within a few days or weeks.

Serious but Rare Concerns

• Liver enzyme elevation
• Severe allergic reaction
• Precipitated opioid withdrawal (if opioids are still in your system)

This is why medical supervision is essential.

If you experience severe abdominal pain, yellowing of the skin or eyes, confusion, or intense withdrawal symptoms, seek medical care immediately.

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Medically Approved Steps to Address Cravings

Medication is just one part of recovery. Evidence-based care usually includes a combination of the following:

1. Speak to a Doctor

This is the most important step.

A healthcare provider can:

• Confirm whether alcohol or opioid use disorder is present
• Rule out other medical causes
• Order liver function tests
• Determine if naltrexone is safe for you
• Discuss other medication options if needed

If symptoms are severe, sudden, or feel life-threatening, seek urgent medical attention immediately.

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2. Consider Medication-Assisted Treatment (MAT)

Medication-assisted treatment combines FDA-approved medications (like naltrexone) with counseling.

For alcohol use disorder, options may include:

• Naltrexone
• Acamprosate
• Disulfiram (in selected cases)

For opioid use disorder:

• Naltrexone
• Buprenorphine
• Methadone

Your doctor will help determine the safest and most effective approach.

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3. Address Triggers and Behavioral Patterns

Medication reduces cravings—but habits and triggers still matter.

Common triggers include:

• Stress
• Social situations
• Loneliness
• Specific times of day
• Emotional distress

Working with a therapist trained in addiction treatment can help you:

• Identify patterns
• Develop coping strategies
• Build healthier routines
• Strengthen motivation

Cognitive behavioral therapy (CBT) is especially effective.

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4. Build a Support System

Recovery is easier when you're not alone.

Support options include:

• Individual therapy
• Group therapy
• Peer support groups
• Trusted family or friends

Support reduces isolation and improves accountability.

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5. Monitor Progress and Adjust

Recovery is rarely linear. Some people need dose adjustments or a different medication. Others benefit from switching from oral naltrexone to the monthly injection for consistency.

Regular follow-ups allow your doctor to:

• Monitor liver function
• Adjust treatment
• Track progress
• Address side effects

Persistence matters more than perfection.

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Does Naltrexone "Cure" Addiction?

No medication cures addiction. But naltrexone can significantly reduce the intensity of cravings, making behavior change more achievable.

Think of it as lowering the volume on the urge. You still need to choose your actions—but the choice becomes more manageable.

Many people use naltrexone for:

• Several months
• A year or longer
• As part of long-term relapse prevention

The right duration depends on individual risk and progress.

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When to Seek Immediate Help

Certain situations require urgent medical attention:

• Signs of alcohol withdrawal (shaking, seizures, confusion)
• Severe opioid withdrawal
• Thoughts of self-harm
• Severe abdominal pain or jaundice while on naltrexone
• Overdose concerns

Do not delay seeking care in these cases. Withdrawal from alcohol in particular can be life-threatening.

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The Bottom Line

If you can't stop the urge to drink or use opioids, it doesn't mean you're broken. It often means your brain's reward system has adapted to repeated exposure.

Naltrexone is a medically approved, evidence-based treatment that:

• Blocks reward pathways
• Reduces cravings
• Lowers relapse risk
• Supports long-term recovery

It works best when combined with counseling, lifestyle changes, and medical supervision.

If you're noticing troubling patterns and want clarity on whether your symptoms warrant professional attention, Ubie's AI-powered symptom checker can help you document what you're experiencing and have a more productive conversation with your healthcare provider.

Most importantly, talk to a doctor about anything that feels serious, worsening, or life-threatening. Safe, effective treatment is available—and asking for help is a medical decision, not a moral failure.