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What Is the Difference Between Naloxone and Naltrexone? Medications for Alcoholism

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Hear from Ria Health Psychiatrist Dr Paul Linde on the difference between naloxone and naltrexone.

So there’s a medication called naloxone and there’s a medication called naltrexone and the one that we use for treating alcohol use disorder is naltrexone so they’re siblings of each other naloxone is the product name narcan and probably many of you have heard of narcan it’s the medication that’s available either in a nasal spray or in an injectable format

To reverse an overdose of an opioid and as you all know fentanyl overdoses heroin overdoses are deadly and we have the capacity that frontline workers police officers and emts social workers even have the capacity of carrying this those who are working with people with heroin and fentanyl issues naloxone or narcan will reverse the overdose immediately and you

Basically wake up with severe withdrawal and usually pretty angry people but they’re alive naltrexone is not that potent of a blocker an opioid blocker and so they both naloxone and naltrexone work by blocking endogenous opioids or what you may have heard as endorphins or encephalins our body produces its own opioids endogenous opioids and essentially the way

That naltrexone works is that it blocks the pleasurable effects of drinking and it literally blocks it by blocking your natural opioids your endogenous opioids and so when people drink smoke cigarettes all sorts of drugs and other pleasurable activities they’re thought to occur through a pleasure pathway and these endorphins or the endogenous opioids are part of

That pleasure pathway so naltrexone basically will make it less likely for people to enjoy a drink make it easier to sort of drink more slowly make it easier to delay the first drink and the goal is that it’s really a tool for people to start meeting their goals of drinking less but it also of course works best in combination with therapy coaching alcoholics

Anonymous etc so an interesting question is that naltrexone when i’m explaining this to patients they say well is that going to make it hard for me to enjoy other things and i really can’t tell you why it doesn’t but it doesn’t seem to having said that there’ll be a really small subset of people on naltrexone who will experience depression um from it and feel

Kind of numb to activities to pleasurable things that they normally do in that case we usually look at an alternative medication because that’s really untenable but it’s remarkable how uncommon it is it’s remarkable to me how often i prescribe naltrexone along with an antidepressant so in other words naltrexone doesn’t seem to worsen depression it seems to work

Pretty specifically for helping people drink less having said that with naltrexone because it is an opioid blocker if for example you have a foot surgery a dental surgery where the surgeon maybe gives you six or eight vicodin or percocet or something you can stop the naltrexone for a couple of days before you need to take it and once you’ve completed a small

Amount of opioid treatment for surgery then you can go back on the other proviso is as a full disclaimer if you’re on naltrexone every day and you break your leg in an accident you’re going to need morphine or some equivalent in an er as long as the er doctor knows that you’re on naltrexone he or she can give you a high enough dose of morphine to overcome the

Naltrexone but i really feel it’s incumbent that people know that um these situations might be unusual but not knowing it if you are taking naltrexone every day and then you take like it in for dental surgery you’re gonna experience a little bit of withdrawal on the bike and it’s not going to work so i sort of feel in full disclosure people need to know that

Before they start taking it for expert support on medication-assisted treatment for alcohol use disorder visit

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What Is the Difference Between Naloxone and Naltrexone? Medications for Alcoholism By Ria Health