Online Alcohol Addiction Treatment: Naltrexone by Telehealth
FDA-approved medications for alcohol use disorder, prescribed online by a licensed physician. Naltrexone and Vivitrol available by telehealth in CA, WA, and NV.
FDA-approved medications to reduce cravings and support recovery from alcohol use disorder, prescribed and managed by a licensed physician via secure video visit. Available in California, Washington, and Nevada. Care is delivered by secure video visit in most locations. In-person visits may be required in the Tacoma, WA and Reno, NV areas.
Alcohol use disorder is a medical condition
Alcohol use disorder (also called alcohol dependence or alcoholism) is a chronic brain condition, not a moral failure or a lack of willpower. It involves changes to the brain's reward system, stress response, and executive function that make controlling alcohol use genuinely difficult, regardless of how much someone wants to stop.
According to the National Institute on Alcohol Abuse and Alcoholism, approximately 29.5 million Americans meet the criteria for alcohol use disorder in any given year. Fewer than ten percent receive treatment. The treatment gap for alcohol use disorder is, if anything, larger than for opioid use disorder.
Effective, FDA-approved medications exist for alcohol use disorder. They are underused, underknown, and underutilized, often because providers and patients alike are unaware they exist, or because stigma prevents patients from seeking help in the first place.
Medications for alcohol use disorder
Naltrexone (oral)
Naltrexone is an opioid antagonist: it blocks opioid receptors in the brain. Because alcohol produces some of its rewarding effects through the opioid system, blocking those receptors reduces the pleasure response to drinking. Over time, the craving diminishes because the brain stops associating alcohol with its usual reward.
Naltrexone is taken as a daily oral tablet. It does not make you sick if you drink. That is a common misconception that confuses naltrexone with disulfiram (Antabuse). It simply reduces the reinforcing effect of alcohol. Many patients find they lose interest in drinking over time.
Naltrexone can also be used with a protocol called the Sinclair Method: taking it specifically before drinking rather than daily, which allows the medication to work during drinking episodes to gradually extinguish the conditioned response.
Vivitrol (injectable naltrexone)
Vivitrol is an extended-release injectable formulation of naltrexone administered once monthly. It produces the same effects as oral naltrexone but eliminates the daily pill, which is a significant advantage for patients who struggle with medication adherence. A monthly appointment is required for the injection.
Acamprosate
Acamprosate works differently from naltrexone: it targets the glutamate system rather than the opioid system, and is thought to reduce the anxiety and restlessness associated with early sobriety. It is most effective for patients who have already stopped drinking and want support maintaining abstinence. Unlike naltrexone, acamprosate does not work if the patient is still drinking.
Which medication is right for you?
Your provider will discuss your situation (your drinking patterns, your goals (abstinence vs. reduction), your other medications, your medical history, and your preferences) and recommend the approach most likely to be effective for you. Many patients do well with naltrexone. Some prefer Vivitrol. Some benefit from combination approaches. There is no single right answer.
What to expect from treatment
Initial visit: A telehealth video visit with a physician. You complete an intake form before the visit covering your drinking history, medical history, medications, and treatment goals. Your provider reviews this before the appointment.
Prescription: Naltrexone is sent electronically to your pharmacy. Vivitrol requires a monthly in-person or in-office injection. Your provider will coordinate this.
Follow-up: Periodic telehealth visits to monitor your response to medication, adjust the approach if needed, and support your progress.
No detox required for naltrexone: Unlike some other medications for alcohol use disorder, naltrexone does not require you to detox before starting. You can begin while still drinking. Acamprosate, however, works best after you have stopped drinking.
Availability by state
| State | Insurance | Availability |
|---|---|---|
| California | Private pay: see California pricing | Telehealth statewide |
| Washington | Most major commercial plans, Medicare, Medicaid/Apple Health, and TRICARE; Kaiser and HMO plans are not accepted; self-pay available | Telehealth statewide + in-person University Place |
| Nevada | Most major commercial plans, Medicare, Medicaid, and TRICARE; Kaiser and HMO plans are not accepted; self-pay available | Telehealth statewide + in-person Reno |
Frequently asked questions
Do I need to stop drinking before I start treatment?
Is naltrexone the same as Antabuse?
Does insurance cover medication for alcohol use disorder?
Can I drink at all while on naltrexone?
How quickly does naltrexone work?
Is alcohol use disorder treatment confidential?
What if I have already tried naltrexone and it did not work?
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