What Happens if You Drink While Using Naltrexone?

Naltrexone, a form of medication-assisted treatment (MAT) for alcohol use disorder (AUD), works by blocking opioid receptors in the brain and thus reducing the pleasurable feelings associated with alcohol consumption.[1] It is also available under the brand name Vivitrol. 

What Negative Effects Occur if You Drink on Naltrexone?

Here’s what you might experience if you drink while on naltrexone:[2]

Reduced Buzz

The primary effect of naltrexone is that you won’t experience the same euphoric effects or “buzz” that alcohol usually provides. This can significantly reduce the motivation to drink more.

Continued Intoxication 

Importantly, naltrexone does not prevent you from becoming intoxicated. If you drink alcohol, you can still experience its impairing effects, including reduced coordination, slurred speech, and poor judgment. You are just less likely to experience the positive or euphoric effects.

Potential for Increased Alcohol Consumption

There’s some concern that because naltrexone diminishes the pleasurable effects of alcohol, some individuals may attempt to compensate by drinking more. This can be dangerous and increase the risk of alcohol-related harm.

Naltrexone Side Effects When Drinking Alcohol

While naltrexone typically has mild side effects on its own, combining it with alcohol could worsen some of these effects. Most side effects of naltrexone are minor and typically clear up on their own. However, severe reactions are possible and warrant medical treatment. If you experience any substantial side effects when using naltrexone, inform your prescribing doctor promptly. 

Possible side effects of naltrexone when drinking alcohol include the following:[2]

• Nausea
• Vomiting
• Headache
• Dizziness
• Fatigue
• Stomach pains 
• Diarrhea 

To reduce the chances of experiencing the above side effects, avoid all alcohol while on naltrexone. 

Will Alcohol Make Me Sick?

Naltrexone doesn’t work in the same way as disulfiram (Antabuse), which causes a severe negative reaction when mixed with alcohol. You are unlikely to have a dramatic physical reaction to drinking on naltrexone. However, drinking alcohol while on naltrexone increases the risk of experiencing negative side effects associated with the medication.[1]

However, drinking alcohol while taking naltrexone can make you sick. How sick you become depends on how much alcohol you consume and your personal reaction to the mix of substances in your body. 

When naltrexone works as it is meant to, you will not have a strong desire or urge to drink alcohol. This is the goal of this treatment, and naltrexone has proven effective in reducing the risk of relapse, lessening alcohol’s euphoric potential, and reducing cravings for alcohol.[3] 

Can You Get a Drunk Feeling on Naltrexone?

While naltrexone blocks the euphoric feelings usually associated with alcohol, you may still experience some intoxicating effects if you continue to drink while on naltrexone. The intoxicating effects you would experience are unlikely to be the pleasurable effects associated with getting drunk. 

The lack of pleasurable effects makes heavy drinking less appealing for most individuals, which is the goal of the medication. Naltrexone purposefully blocks the pleasurable and euphoric effects of alcohol to discourage alcohol use.[1] As a result, future drinking episodes are less likely.

Drinking on Naltrexone: Is It Safe?

Drinking alcohol while on naltrexone is not dangerous, though it is not encouraged. People still using drugs or drinking large amounts of alcohol should not start taking naltrexone, as negative side effects are likely to occur.[2]

Regardless of naltrexone use, it’s crucial to be aware of the dangers of excessive alcohol consumption. Even without the pleasurable effects of drinking, overconsumption can lead to significant health and social problems.[4] If you are struggling not to drink while taking naltrexone, discuss the situation with your prescribing doctor.  They can assess the situation and determine if a change in your treatment plan is needed.

Naltrexone is most effective when combined with behavioral therapy and support groups.[5] Through these various approaches to recovery, individuals learn tools to resist alcohol consumption and maintain long-term sobriety. 

Naltrexone is safe as part of a long-term treatment plan, and alcohol should be avoided when on naltrexone. Focus on a comprehensive treatment plan for sustained recovery from AUD.[5]