Naltrexone

Naltrexone sits on opioid receptors without activating them, which blocks the effects of opioids if someone uses and reduces the urge to drink. It comes as a daily pill or as Vivitrol — a once-monthly injection that removes the need to remember a daily dose.

For opioid addiction, naltrexone requires being fully off opioids for seven to ten days before starting, to avoid triggering sudden withdrawal. That makes it harder to start than buprenorphine for many people. For alcohol use disorder, the evidence is strong and the medication is well-tolerated — it is a first-line option alongside acamprosate.

In luxury residential settings, naltrexone is most often used for alcohol relapse prevention. The Sinclair Method — taking naltrexone before drinking to gradually eliminate the reward — has moved into the mainstream over the last decade.