- Last Modified: May 20, 2026
Drinking alcohol while taking naltrexone reduces the medication’s effect on cravings, raises intoxication, strains the liver and intensifies side effects, and abstinence remains part of naltrexone treatment.
Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) are significant public health challenges in the United States, reaching millions of people and producing severe health, social and economic consequences.
An estimated 14.4 million adults had AUD in 2019, and 2.1 million people had OUD in 2020. Access to effective treatment remains limited, and only a small percentage of people receive the help they need. Medication-assisted treatment, including naltrexone, is a crucial component in managing these disorders.
Naltrexone requires 7 to 10 days free of all opioids before the first dose. Taking naltrexone while opioids remain in the body produces sudden, severe precipitated withdrawal, which is a medical emergency. Tell your prescriber about every opioid you have taken, including prescription pain medication.
The sections below cover how naltrexone works, its forms, the risks of combining it with alcohol, and why professional support matters in recovery.
What Is Naltrexone?
Naltrexone is an opioid antagonist that blocks opioid receptors in the brain, which reduces cravings for alcohol and opioids and removes their rewarding effect.
Naltrexone treats Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD). Naltrexone belongs to the opioid receptor antagonists, a drug class that blocks the effects of opioids on the brain. Naltrexone reduces cravings and diminishes the rewarding effects of alcohol and opioids, which supports recovery.
As an opioid antagonist, naltrexone occupies the opioid receptors and reduces the dopamine released in the nucleus accumbens, the brain’s reward center. That occupancy competitively displaces opioid medications from their binding sites.
The opioid antagonist properties of naltrexone suit people with a history of opioid misuse or dependence who are seeking AUD treatment, because naltrexone reduces the rewarding effects of and cravings for both opioids and alcohol.
How Does Naltrexone Work?
Naltrexone binds to opioid receptors and blocks the pleasurable effects of alcohol and opioids, which breaks the reinforcement cycle that sustains addiction.
Removing the reward is what distinguishes naltrexone from a medication that treats withdrawal. Naltrexone suppresses cravings for alcohol and opiate drugs, and naltrexone does not treat the withdrawal symptoms that follow stopping a substance abruptly.
Naltrexone is an effective tool in addiction treatment, and it works best as part of a comprehensive treatment plan that includes counseling and support.
Can You Drink Alcohol While Taking Naltrexone?
No. Naltrexone does not make drinking safe: alcohol reduces the medication’s effectiveness and raises the risk of adverse effects, and abstinence remains part of the treatment.
Naltrexone is prescribed to manage opioid and alcohol cravings, and understanding the risks, adverse reactions and effects of combining naltrexone with alcohol matters before starting the medication.
Naltrexone is an effective aid in addiction treatment, and it provides no green light for drinking alcohol. Naltrexone is not a cure for addiction, and abstaining from alcohol or substance use remains an integral part of recovery. Drinking alcohol on naltrexone diminishes the medication’s effectiveness and raises the risk of adverse effects.
What Are the Risks of Mixing Naltrexone and Alcohol?
Mixing naltrexone and alcohol reduces the medication’s effectiveness, raises intoxication, obscures opioid tolerance, strains the liver and intensifies side effects.
Naltrexone reduces the rewarding effects of alcohol without eliminating them. The reduction invites the conclusion that drinking on naltrexone carries no consequence, and combining the two carries real risks.
There are 5 risks of combining naltrexone with alcohol:
- Reduced medication effectiveness: Alcohol interferes with the ability of naltrexone to reduce cravings and prevent relapse. Alcohol consumed on naltrexone diminishes the medication’s block on the pleasurable effects of alcohol, which drives higher alcohol consumption.
- Intensified alcohol effects: Naltrexone does not alter the intoxicating effects of alcohol, so alcohol consumed on naltrexone produces heightened intoxication. Heightened intoxication produces impaired judgment, coordination difficulties and a raised risk of accidents and injuries.
- Risk of overdose: Naltrexone blocks the effects of opioids, which lowers overdose risk for a person previously dependent on opioids. Alcohol consumed on naltrexone leads a person to underestimate their opioid tolerance, which raises overdose risk where opioids are used.
- Liver function: Naltrexone and alcohol both act on liver function. Alcohol consumed on naltrexone strains the liver further, worsens existing liver conditions and produces liver failure. Discuss any liver concern with a healthcare professional.
- Side effect intensification: Naltrexone and alcohol both produce side effects. Combining the two raises the severity and frequency of dizziness, nausea and gastrointestinal discomfort.
The specific risks and interactions vary with individual factors including overall health, addiction history and naltrexone dosage. Consult a healthcare professional for advice on mixing naltrexone and alcohol in your situation.
The goal of naltrexone treatment is supporting recovery and abstinence from alcohol and opioids. Prioritize sobriety and abstain from alcohol through the course of naltrexone treatment.
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What Are the Side Effects of Naltrexone?
Naltrexone produces nausea, headache, dizziness, fatigue and abdominal pain, and alcohol intensifies every one of them alongside sedation and impaired coordination.
Naltrexone carries the potential to produce side effects, as any medication does. Knowing those effects matters, because the interaction with alcohol intensifies them and adds further dangers.
There are 5 common naltrexone side effects:
- nausea
- headache
- dizziness
- fatigue
- abdominal pain or gastrointestinal discomfort
Mixing alcohol with naltrexone produces increased sedation and drowsiness, which impairs the ability to drive or operate machinery safely. The combination heightens the risk of coordination difficulties, confusion and difficulty concentrating, and those effects impair judgment and cognitive ability.
Combining naltrexone and alcohol also raises the risk of liver damage. Naltrexone and alcohol each act on liver function, and the combination compounds that risk.
How Effective Is Naltrexone, and What Does the Research Show?
Naltrexone is FDA-approved and reduces heavy drinking and promotes abstinence in moderate-to-severe alcohol dependence, and it works alongside counseling rather than on its own.
Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) are serious conditions that require effective treatment. The Food and Drug Administration has approved disulfiram, acamprosate and naltrexone for alcohol and opioid dependence. Topiramate shows effectiveness and has not received FDA approval for treating alcohol dependence. A combination of therapeutic interventions reaches the best outcome in some cases.
Naltrexone reduces heavy drinking and promotes abstinence in people with moderate-to-severe alcohol dependence. Naltrexone suits a person who has failed attempts to quit drinking and remains motivated to try abstinence. Abstain from drinking for the period your prescriber sets before starting naltrexone therapy, and medical assistance is necessary for withdrawing from alcohol safely.
Medication-assisted therapy works alongside psychosocial interventions including counseling, support groups and behavioral therapies, which is what achieves long-term recovery. Seeking professional help matters for anyone living with AUD or another substance use disorder.
Addiction is a complex condition that requires comprehensive treatment plans. Many treatment options exist, and finding a trusted facility with healthcare professionals dedicated to compassionate care is what supports lasting recovery.
Where Can You Find Support Near You?
Riverside Recovery of Tampa treats alcohol use disorder and opioid use disorder, including medication-assisted treatment with naltrexone alongside counseling and support.
Riverside Recovery of Tampa understands the challenges of addiction and supports you at every step. Contact us today to speak with one of our admissions team members and start your journey toward a healthier, substance-free life.
Recovery is possible, and facing it alone is not required. Reach out to us today and take the first step.
Disclaimer: The information in this article is for educational purposes and is not medical advice. Consult a healthcare professional for guidance on your specific situation.
- National Institute on Drug Abuse. (2020, April 14). Naltrexone: https://nida.nih.gov/publications/drugfacts/naltrexone
- Substance Abuse and Mental Health Services Administration. (2015). Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series, No. 43. HHS Publication No. (SMA) 15-4214.
- National Institute on Alcohol Abuse and Alcoholism. (2021, May 11). Treatment for Alcohol Problems: Finding and Getting Help: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-getting-help
- Anton R. F. (2008). Naltrexone for the management of alcohol dependence. The New England Journal of Medicine, 359(7), 715-721. https://doi.org/10.1056/NEJMct0801733
- Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series, No. 49, Chapter 4, Oral Naltrexone: https://www.ncbi.nlm.nih.gov/books/NBK64042/