Frequently asked Questions

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HOW DOES NALTREXONE HELP IN TREATING ALCOHOLISM?
Reports from successfully treated patients suggest three kinds of effects. First, it reduces cravings, which is the urge or desire to drink. Second, it helps patients remain abstinent. And, third, it can interfere with the tendency to want to drink more if a recovering patient slips and has a drink, preventing them from escalating into a full-blown relapse. Finally, Naltrexone also helps to repair receptors so that your own brain chemicals can function properly allowing you to get high on life!

DOES THIS MEAN IT WILL SOBER ME UP IF I DRINK?
​No, it does not reduce the effects of alcohol that impair coordination and judgment.

IF I TAKE NALTREXONE, DOES IT MEAN THAT I DON’T NEED ANY OTHER TREATMENT FOR ALCOHOLISM?
No, it is not recommended to be prescribed as a stand-alone medication. We use it as only one component of a program of treatment for alcoholism including counseling, help with associated psychological and social problems, and participation in self-help groups. In studies where the medication was shown to be effective, it was combined with treatment from professional psychotherapists.

HOW LONG DOES IT TAKE TO START WORKING?
The effects on blocking opioids occur shortly after taking the first dose. Findings to date suggest that its effects in helping patients remain abstinent and avoid relapse to alcohol use also occur early.​

WHAT DOES IT FEEL LIKE TO BE ON NALTREXONE?
Aside from side effects, which are usually short-lived and mild, patients usually report that they are largely unaware of being on medication. It usually has no psychological effects and patients don’t feel either “high” or “down” while taking it. It is not addicting. While it does seem to reduce alcohol craving, it does not interfere with the experience of other types of pleasure.

WHAT ARE THE SIDE-EFFECTS OF NALTREXONE?
In the largest study, the most common side effect affected only a small minority of people and included the following: nausea (10%), headache (7%), dizziness (4%), fatigue (4%), insomnia (3%), anxiety (2%), and sleepiness (2%). These side effects were usually mild and of short duration. When used as a treatment for alcoholism, the side effects have caused 5-10% of people studied to discontinue the use of the medication. For most patients, side effects are mild or of brief duration. One potential side effect is that the medication can have an adverse effect on the liver. We have found in most cases that continuing drinking is much more harmful to the liver than Naltrexone. Blood tests of liver function are performed prior to the onset of treatment and periodically during treatment to determine whether medication should be started and whether it should be discontinued if the relatively rare side effect of liver toxicity is taking place. However, taking this medication is much less dangerous than continuing to drink if some liver damage is present.

DO I NEED TO GET BLOOD TESTS? HOW OFTEN?
To ensure that this treatment is safe, blood tests should be obtained prior to initial treatment. Following that, re-testing generally occurs at monthly intervals for the first three months, with less frequent testing after that point. More frequent testing may be requested depending on the health of your liver prior to beginning treatment. Blood tests are needed to make sure that liver function is adequate prior to taking the medication and to evaluate whether it is having adverse effects on the liver.

CAN I TAKE OTHER MEDICATIONS AT THE SAME TIME?
The major active effect of this medication is on opioid drugs, which is one class of drugs used primarily to treat pain but is also found in some prescription cough preparations. It will block the effect of normal doses of this type of drug. There are many non-narcotic pain relievers that can be used effectively while you are taking it. Otherwise, it is likely to have little impact on other medications patients commonly use such as antibiotics, non-opioid analgesics (e.g., aspirin, acetaminophen, ibuprofen), and allergy medications. You should inform your physician of whatever medication you are currently taking so that possible interactions can be evaluated. Because it is broken down by the liver, other medications that can affect liver function may affect what dosage you are prescribed.

WILL I GET SICK IF I DRINK WHILE TAKING NALTREXONE?
No. It may reduce the feeling of intoxication and the desire to drink more, but it will not cause a severe physical response to drinking.

WILL I GET SICK IF I SUDDENLY STOP TAKING NALTREXONE?
This medication does not cause physical dependence and it can be stopped at any time without withdrawal symptoms. In addition, available findings regarding cessation do not show a “rebound” effect to resume alcohol use when it is discontinued.

WHAT SHOULD I DO IF I NEED AN OPERATION OR PAIN MEDICATION?
We will provide you with a card explaining that you are on this medication and that also instructs physicians on pain management. Many pain medications that are not opioids are available for use. If you are going to have elective surgery, the medication should be discontinued at least 72 hours beforehand.

WHAT IS THE RELATIONSHIP OF THIS PROGRAM TO AA?
There is no contradiction between participation in AA and taking this medication. It is not addictive and does not produce any “high” or pleasant effects. It can contribute to the achievement of an abstinence goal by reducing the craving or compulsion to drink, particularly during the early phases of recovery. It is most likely to be effective when the patient’s goal is to stop drinking altogether.

WHY SHOULD MY FAMILY BE INVOLVED?
Alcohol and drug addiction affect the entire family. Substance abuse therapists may educate the family members about substance abuse. They may also provide marriage counseling and family counseling to help rebuild damaged family relationships.

WHAT IS THE PRIMARY ROLE OR PURPOSE OF SEEING COUNSELOR?
The primary role occupied by a therapist or counselor is to provide both individual and group counseling sessions. A counselor may also provide marriage counseling and family counseling as needed. Counseling sessions usually focus on stabilizing the client but then may delve into past traumas and the reasons the client took up drinking or drugs in the first place. Counseling sessions also provide support as clients work to maintain their sobriety.

WHAT KINDS OF EDUCATION DO THE COUNSELORS OR GROUPS PROVIDE? WHY DO I NEED TO GO TO GROUP THERAPY
Counselors educate clients about substance abuse and the recovery process. Topics include the dynamics of addiction, health risks caused by alcohol and drug abuse, stress management, coping skills, problem-solving skills, communication skills, healthy relationships, and relapse prevention.

HOW LONG SHOULD I CONTINUE TAKING NALTREXONE?
If the medication is tolerated and the patient is successful in reducing or stopping drinking, the recommended initial course of treatment is six months. At that time the patient and clinical staff should evaluate the need for further treatment on the basis of the degree of improvement, degree of continued concerns about relapse, and level of improvement in areas of functioning other than alcohol use.

WHAT IS SUBOXONE?
Suboxone is a sublingual tablet that contains Buprenorphine HCL as well as Naloxone HCL dihydrate. It is used for the treatment of opiate addictions such as Vicodin, Oxycontin, Lortab, Percodan, Percocet, Stadol, Demerol, Dilaudid, Codeine, Heroin, and Methadone. It is a Schedule III Narcotic under the Controlled Substances Act.

WHAT IS SUBUTEX?
Subutex is a sublingual tablet that contains Buprenorphine HCL only. Buprenorphine HCL is a partial antagonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor. Like Suboxone, Subutex is a Schedule III Narcotic under the Controlled Substances Act.

CAN SUBOXONE/SUBUTEX BE USED IN THE TREATMENT OF COCAINE ADDICTION?
While cocaine addiction is a serious medical problem, it cannot be treated with either Suboxone or Subutex, as those medications are used strictly in the treatment of opioid abuse.

I AM CURRENTLY ON METHADONE. WOULD I BE ABLE TO SWITCH TO SUBOXONE?
Yes, you can easily switch from Methadone to a Buprenorphine HCL based medication.

CAN ANY PHYSICIAN PRESCRIBE SUBOXONE/SUBUTEX?
No. Under the Drug Addiction Treatment Act (DATA) of 2000, prescription use of these medications in the treatment of opioid dependence is limited to physicians who meet certain qualifying requirements and must have written notification to the Secretary of Health and Human Services of their intent to utilize Buprenorphine HCL for the treatment of opioid dependence.

DO YOU ACCEPT INSURANCE OR ASSIGNMENT OF BENEFITS?
We recognize the difficulties encountered by many in dealing with insurance carriers, therefore we will assist in filing your insurance. However, we do require that you pay at least 50% upfront and your insurance company is directed to reimburse you.