How Long Does Naltrexone Take to Work?

How long it takes naltrexone to work depends on which effects you’re looking at as well as personal variables that can speed up or slow down how naltrexone is processed in the body.

What You'll Learn:

• Why some naltrexone effects are immediate and others take time.

• How long naltrexone has to be in your system to kill the buzz of alcohol.

• The typical timeline for the effects of naltrexone to curb alcohol cravings.

• Why the timing for naltrexone results varies from person to person.

• The long-term benefits of taking naltrexone.

Asking how long it takes for naltrexone to work is actually a nuanced question. There are a few different answers depending on what you mean by working. Unlike other medications, naltrexone has both near instant effects and long-term effects that gradually build over time.

This dual-action mechanism is part of the reason why naltrexone is highly effective for treating alcohol use disorder.

Immediate Versus Long-Term Naltrexone Effects

Naltrexone works in two primary ways to help people take control of their drinking. One effect is experienced soon after the first dose while the other takes time after consistently using naltrexone.

Preventing the Pleasurable Buzz: Most people notice an immediate difference when drinking after taking naltrexone. The medication works from the first dose to block opioid receptors, prevent the release of dopamine and blunt the pleasurable buzz of alcohol.

Curbing Alcohol Cravings: This is the effect that takes time because it involves altering the reward pathways of the brain, which doesn’t happen from a single experience. Each time you drink alcohol while taking naltrexone and don’t get a buzz, it disassociates the connection between alcohol and pleasure. Over a short period of time, you’ll crave alcohol less since it doesn’t have the pleasurable effects anymore. The longer you take it the less you’ll crave alcohol.

How Soon Naltrexone is Taken Before Drinking For It to Work

Eliminating the dopamine release from drinking alcohol isn’t quite immediate. In order to ensure the opioid receptors are inhibited, you have to take naltrexone at least an hour before drinking. There needs to be a little time for the medication to be processed by the body.

If It’s been 24+ hours since your last naltrexone dose, you’ll need to take another one prior to drinking. A standard 50mg tablet of naltrexone remains active in your system for about a day.

The Typical Timeline For Feeling the Effects of Naltrexone

For most patients, there’s a typical timeline for how long it takes naltrexone to work. The general rule of thumb is:

First 1 to 3 Days

Pleasurable effects of drinking alcohol aren’t felt the same from the first dose. Mild naltrexone side effects may appear as the body adjusts to the medication.

1 to 2 weeks

In the first few weeks of taking naltrexone cravings often begin to decrease with each instance of drinking that doesn’t produce a dopamine release.

3 to 4 weeks

Many people notice a clear difference in drinking behavior as the cravings subside substantially.

To fully end the cravings and change your drinking behaviors a patient should take naltrexone for a minimum of three months. However, unless you plan to never drink again, you’ll need to continue taking naltrexone to keep alcohol cravings from coming back.

Why the Time It Takes For Naltrexone to Work Varies

How long it takes for naltrexone to work is similar for most but not all people. Here again there are different factors depending on whether you’re considering the immediate effects of naltrexone versus the long-term effects.

The dopamine reducing effects can set in at slightly different rates due to:

• Metabolism

• Liver health

• Kidney function

• Age and genetics

• Body mass

• Hydration

In terms of curbing alcohol cravings, how long it takes depends on:

• Your alcohol consumption history

• Your consistency with taking naltrexone

• If you are reinforcing it with support programs or therapy

One is influenced by physical factors while the other is behavioral. It’s a good idea to discuss these factors with your prescribing clinician so you have a better idea of your personal timeline.

Long-Term Benefits of Taking Naltrexone Regularly

Naltrexone is impressive in how quickly it can change the experience of drinking alcohol. But it’s the long-term benefits that come with prolonged use that are really impressive.

Over time, the brain learns that alcohol produces less reward. This process is called pharmacological extinction. The result is a gradual reduction in drinking motivation until you have very little, if any, desire to drink alcohol.

This long-term benefit is crucial for anyone who wants to maintain their sobriety and reduce the risk of relapse by at least 14% while extending sobriety for twice as long compared to staying sober without naltrexone.

Some patients use targeted dosing long-term. This means taking naltrexone before drinking versus every day. Targeted dosing isn’t always recommended because you could find yourself in a drinking situation without your medication.

Pharmacological extinction can quickly be undone with just one drinking episode where you feel the euphoric effects of alcohol. It’s a strong reminder for the reward system to associate alcohol with pleasure and make the cravings come back. The safest bet is to take naltrexone daily, which has been proven safe even with long-term use.

If you want to start benefiting from the effects of naltrexone, take our Alcohol Use Assessment. It provides a clear picture of your current drinking behaviors and how frequently you consume alcohol. You’ll also receive recommendations for supporting your goals, including if naltrexone could be beneficial.