Lance M. Dodes, M.D.

I am wondering what Dr Dodes thinks about the use of Naltrexone in alcoholism. I was prescribed it not quite a year ago. It has helped a lot in limiting the number of episodes of binge drinking I had been experiencing, to the point that I'm fairly convinced that Naltrexone goes a long way towards "harm reduction" without total abstinence.

Thanks

Thanks for your post. Harm reduction, by definition, can only be a good thing. Naltrexone has not proven to be very effective for most people, for many reasons, but it's good that you find it helpful.

Naltrexone is most effective when it isn't taken daily. When the addiction has been learned as a conditioned behavior, it can be unlearned by canceling the opiate "reward" via an opiate blocker like naltrexone, but for best effect the blocker should be taken only prior to drinking alcohol. This is popularly known as "the Sinclair Method."

Daily naltrexone use isn't terrifically effective. It's better than doing nothing at all, but it's not nearly as good as targeted use.

Here's something I wrote a while ago on naltrexone and alcohol.