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Wondering if naltrexone for alcohol cravings really works? For many people, it may help. Naltrexone is an FDA-approved medication that has been shown to lower the urge to drink and reduce heavy drinking days when it is part of a full treatment plan. It is not a cure and not a quick fix. Used with counseling and follow-up, it may make cutting back or stopping feel more manageable.
This guide covers 7 clear facts: how the medication works, who it may help, what to expect, and how to start. The information comes from a MATE-certified provider in Burbank who treats alcohol use disorder in person and by telehealth across California.
Naltrexone is a prescription medication used to treat alcohol use disorder and opioid use disorder. For alcohol, it works inside the brain’s reward system. It blocks certain opioid receptors that help make drinking feel good. When those receptors are blocked, alcohol may feel less rewarding, and the pull to keep drinking may fade.
The National Institute on Alcohol Abuse and Alcoholism lists naltrexone as one of three medications approved in the United States for alcohol use disorder. It is non-addictive and is not a controlled substance. You cannot get high from it, and stopping it does not cause withdrawal the way some other medications can.
Naltrexone comes in two forms. One is a daily tablet, sometimes sold as ReVia. The other is a once-monthly injection called Vivitrol. Each form has trade-offs around routine, cost, and consistency. Your provider helps you pick the one that fits your life. For a closer look at both, see our guide to Vivitrol and naltrexone treatment in Burbank.
Naltrexone for alcohol cravings works on the brain’s reward loop. Drinking triggers a release of feel-good signals tied to opioid receptors. That release is part of why alcohol can be hard to put down once you start. Naltrexone blocks those receptors, so the usual lift from drinking may feel weaker.
This may help in two ways. Between drinking episodes, cravings may feel less intense. And if a person does drink while taking it, the experience may feel flatter, which may make it easier to stop sooner. Evidence suggests the medication may reduce heavy drinking days for many people, though the effect is different for everyone.
Naltrexone does not make you sick if you drink. That sets it apart from disulfiram, an older medication that causes an unpleasant reaction with alcohol. Naltrexone simply turns down the reward, so the choice to stop may feel a little easier.
The main reason naltrexone for alcohol cravings may work is the way it changes the reward response. Alcohol use disorder is not about willpower alone. Over time, the brain learns to link drinking with relief and pleasure. That learned link drives cravings, even when a person truly wants to stop.
By blocking opioid receptors, the medication may weaken that link. The brain still remembers the habit, but the payoff feels smaller. With repeated days on treatment, some people notice the automatic urge to drink loses some of its grip. This is one reason naltrexone is used as part of medication-assisted treatment for alcohol.
Naltrexone is available in two forms, and the choice matters. The daily tablet gives you control and is easy to stop if needed. The trade-off is that you have to remember it every day, which can be hard early in treatment.
The monthly injection, Vivitrol, removes the daily step. One shot in the office covers about four weeks. For people who struggle with daily routines, this steady coverage may support more consistent results. The trade-off is cost and a monthly office visit. Your provider reviews both and helps you decide which fits your goals.
Many people believe they must be fully sober before any alcohol medication can help. With naltrexone for alcohol cravings, that is often not the case. Some providers use an approach where you take the medication and keep living your life, then let the reduced reward slowly shrink your drinking over weeks.
This may lower heavy drinking days even when full abstinence is not the first goal. It can be a gentler on-ramp for people who feel overwhelmed by the idea of quitting all at once. Your provider will explain whether this fits your history and set clear, realistic goals with you. The medication can support both cutting back and full abstinence.
One common worry is whether you are trading one dependence for another. With naltrexone, the answer is no. It does not cause a high, it is not habit-forming, and it is not a controlled substance. You will not crave the medication, and stopping it does not trigger withdrawal.
There are still things to watch. Naltrexone blocks opioids, so it must not be used while opioids are in your system, and it is not right for people who need opioid pain treatment. Always give your provider a full list of your medications before you start, so your plan is safe.
Medication is one tool, not the whole plan. Evidence suggests that naltrexone for alcohol cravings works better when it is paired with counseling, peer support, or therapy. The medication may lower the pull to drink, while counseling helps you build new habits and handle the triggers that led to drinking.
The Substance Abuse and Mental Health Services Administration supports combining medication with behavioral support for alcohol use disorder. At our practice, we build plans that pair medication with counseling and regular check-ins. To see how our team approaches recovery, read our overview of care from an addiction psychiatrist in Los Angeles.
Like any medication, naltrexone can cause side effects, but for most people they are mild and fade within the first days or weeks. Common ones may include nausea, headache, tiredness, dizziness, or trouble sleeping. Taking the tablet with food may ease stomach upset.
The monthly shot can cause soreness at the injection site. Serious problems are uncommon. Because naltrexone is processed by the liver, your provider may check liver health before and during treatment, especially if you have a history of liver issues. Tell your provider about any side effect that lasts or worries you, so the plan can be adjusted.
Cost is a common barrier, but it may be smaller than you expect. Generic oral naltrexone is often inexpensive, and many major insurance plans cover both the tablet and the Vivitrol injection for alcohol use disorder. Coverage and copays vary by plan and by which form you use.
At LA Integrative Psychiatry, we accept Anthem, Aetna, Cigna, UnitedHealthcare, and Medicare, and our team verifies your benefits before you start so you know the real cost. If you are paying out of pocket, ask about generic tablets and pharmacy discount programs, which can bring the price down.
Naltrexone is not the right fit for everyone, but it may help in several situations. Consider talking with a provider about it if any of these apply:
People who need opioid pain treatment, who are pregnant, or who have certain liver conditions may need a different plan. A full evaluation is the only way to know if naltrexone for alcohol cravings is a safe fit for you.
The first step is a full evaluation with a provider. This visit reviews your drinking history, other substances, medical history, mental health, and current medications. It can happen in person in Burbank or by telehealth. If the medication looks like a good fit, you and your provider agree on a form, a dose, and a start date.
If you use the oral tablet, you take it once a day, often at the same time. If you choose Vivitrol, you get the injection in the office about once a month. Either way, your provider schedules check-ins to see how you are doing, adjust the plan, and support the counseling side of your care. This is a plan you follow with a team, not something you manage alone.
Naltrexone is one of a few medications used for alcohol use disorder, and each works differently. Understanding the basics may help you and your provider choose.
There is no single best choice for everyone. The right option depends on your history, your goals, your other health conditions, and your preferences. A provider who treats alcohol use disorder can walk you through the trade-offs and help you pick.
Starting treatment begins with one conversation. At LA Integrative Psychiatry, our MATE-certified provider evaluates whether naltrexone for alcohol cravings fits your history and goals, then builds a plan that pairs it with counseling and follow-up. Care is available in person at our Burbank office and by telehealth across California.
You do not have to have everything figured out before you call. The first visit is a judgment-free space to talk through your drinking, your goals, and your options. If naltrexone is not the right fit, your provider will help you find a plan that is. To learn more about our full range of care, see our addiction treatment options.
Some people notice a change within the first week or two, while others take longer. The effect may build over time as the medication and your routine settle in. Your provider tracks your response and adjusts the plan during follow-up visits.
Naltrexone does not make you sick if you drink, unlike disulfiram. Drinking may simply feel less rewarding. Some plans use this on purpose to help reduce heavy drinking over time. Your provider will explain what to expect and set goals with you.
There is no fixed timeline. Some people take it for a few months, others for a year or more. The right length depends on your goals, your response, and your provider’s guidance. Any change should be made with your provider, not on your own.
Many major plans cover it for alcohol use disorder, including both the tablet and the Vivitrol injection. Coverage and copays vary. Our team verifies your benefits before you start so there are no surprises.
In many cases, yes. Much of the care, including the evaluation and oral prescriptions, can happen by video in California. The Vivitrol injection is given in the office. Your provider will explain what applies to your situation.
Naltrexone for alcohol cravings may help lower the urge to drink and reduce heavy drinking days when it is part of a full plan. It is non-addictive, comes as a daily pill or a monthly shot, and works best alongside counseling and support. For many people, it is a practical tool that makes change feel more within reach.
Schedule a consultation today at our Burbank office or by telehealth anywhere in California. We accept most major insurance and verify your benefits before your first visit. A MATE-certified provider can help you decide if this treatment is right for you.
Medically reviewed by Knarik Oganesyan, FNP-C, PMHNP-BC (MATE-certified). Last updated July 2026. This article is for educational purposes and is not a substitute for personalized medical advice. If you are in crisis or having thoughts of self-harm, call or text 988 for the Suicide and Crisis Lifeline. SAMHSA’s National Helpline is available 24/7 at 1-800-662-HELP (4357). Always talk with your provider before starting or changing treatment.
