Treatment plans using naltrexone ideally respond to individual
patient needs. In that regard, practitioners may want to consider the
following evidence-based conclusions:
1. Naltrexone is effective in a variety of alcoholism-treatment settings
where motivation to stay in treatment, avoid relapses to
heavy drinking, and take medications is supported by appropriate
2. Naltrexone may be especially useful in repeat alcohol relapsers,
by reducing the frequency and scope of drinking episodes to
allow continued progress toward recovery goals.
3. Individualized naltrexone dosing regimens can be of benefit,
possibly starting at lower doses and titrating upward.
4. Alcohol abstinence prior to initiating naltrexone therapy may
not be necessary in all cases.
5. Extended daily use of naltrexone may be helpful: longer-term
therapy (6 to 9 months) can be more effective than short-term (3
6. Following daily therapy, naltrexone might be used on an asneeded,
“targeted,” basis indefinitely.
Research results require careful consideration. Statistical significance
of outcomes is important but can be misleading, for even
small improvements can be clinically and socially significant when
each percentage point may represent thousands of lives benefitted.
As Enoch Gordis, MD, former Director of the National Institute on
Alcohol Abuse and Alcoholism (NIAAA), once observed, “While
not a ‘magic bullet,’ naltrexone promises to help many patients
in their struggle against chronic relapsing disease”