Naltrexone Treatment for Alcohol and Opioid Use Disorder
Naltrexone prescribed by telehealth for alcohol use disorder and opioid use disorder. Oral daily medication, physician-managed. Available in California, Washington, and Nevada.
Naltrexone is unusual among addiction medications: a single drug that is FDA-approved to treat both alcohol use disorder and opioid use disorder, and one that contains no opioid and creates no dependence of its own. It works by closing a door rather than occupying a chair, blocking the receptors that drive reward instead of activating them. Rezolv Health prescribes and manages oral naltrexone by telehealth in California, Washington, and Nevada.
How naltrexone works
Naltrexone is an opioid antagonist. It binds to the same mu-opioid receptors that opioids and the brain's own reward chemistry use, but instead of switching them on, it blocks them and keeps anything else from switching them on either. With those receptors occupied by an inert blocker, two things happen. If a person drinks alcohol, the surge of feel-good signaling that normally reinforces drinking is muted, so the act becomes less rewarding and easier to walk away from. If a person takes an opioid, it simply cannot produce a high. The receptor is already closed.
Because it interrupts the reward rather than satisfying it, naltrexone gradually weakens the learned link between the substance and the relief or pleasure the brain expects. For alcohol especially, many patients describe it as turning the volume down on cravings and on the "one drink leads to five" momentum.
Two FDA approvals, two different jobs
Naltrexone is approved for alcohol use disorder and for opioid use disorder, but it does each job differently.
For alcohol use disorder, it is one of the most useful tools available and pairs naturally with the rest of our alcohol addiction treatment. Patients can keep taking it whether or not they have achieved full abstinence, and it supports both moderation and sobriety goals.
For opioid use disorder, naltrexone is an option for people who are already off opioids and want a non-opioid medication that removes the possibility of getting high. It does not relieve withdrawal the way buprenorphine does, so it suits a different stage of recovery rather than the earliest, still-using phase.
How it differs from buprenorphine
The contrast with buprenorphine is the clearest way to understand naltrexone. Buprenorphine is an agonist: it gently activates opioid receptors to relieve withdrawal and cravings. Naltrexone is the opposite: a pure blocker with no opioid activity at all. That difference drives three practical distinctions.
First, naltrexone is not a controlled substance and carries no potential for misuse or diversion. Second, it produces no physical dependence, so stopping it causes no withdrawal. Third, it offers no relief from active opioid withdrawal and this is the catch that makes timing essential.
The opioid-free requirement
Because naltrexone displaces opioids from the receptor, taking it while opioids are still in your system can trigger sudden, severe precipitated withdrawal. For that reason, a person must be fully off all opioids before starting, generally about 7 days for short-acting opioids and 10 to 14 days for longer-acting ones. Your physician will confirm you are ready before you begin, sometimes with a supervised challenge. This requirement is why naltrexone is better suited to patients who have already detoxed than to those still using.
There is no comparable waiting period for using naltrexone in alcohol use disorder.
Oral naltrexone versus the injection
This page covers oral naltrexone: a daily tablet you take at home. The same molecule also exists as a once-monthly intramuscular injection sold as Vivitrol, which removes the need to remember a daily pill but requires an in-person injection. If consistent daily dosing is a concern for you, the monthly option may be a better fit; see our Vivitrol treatment page for how that works and where it is available.
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
Can naltrexone treat both drinking and opioid use?
Is naltrexone addictive?
Why do I have to be off opioids before starting naltrexone?
How is naltrexone different from Suboxone or buprenorphine?
What happens if I drink while taking naltrexone?
What if I need an opioid for pain or surgery while on naltrexone?
Do I need to come in person to take oral naltrexone?
Ready when you are
Ready to get started?
Complete our short intake quiz and get matched to the right care.