Which statement about naltrexone is true?

• A. It is a narcotic and opioid agonist
• B. It is an opioid antagonist indicated for both opiate and alcohol dependence and is not addictive, not a narcotic, and has no withdrawal
• C. It is a non-narcotic analgesic used for pain
• D. It must be used after 60 days of abstinence

Answer: (B)

Naltrexone works by blocking opioid receptors, so opioids can’t produce their rewarding effects. That blocking action makes it useful for helping people stay off opioids and also for treating alcohol dependence, since the pleasurable effects of alcohol aren’t enhanced by opioids in the brain. It is not a narcotic and it is not addictive, so there’s no inherent dependence on it and no withdrawal syndrome simply from stopping the medication. It is not an analgesic, so it isn’t used to treat pain. It’s approved for both opioid dependence and alcohol dependence.

The statement about needing 60 days of abstinence before starting naltrexone isn’t correct. You simply need to be opioid-free before initiating therapy to avoid precipitated withdrawal, but the required abstinence period isn’t fixed at 60 days and varies with the opioid involved and the formulation used. If opioids are still in the system, starting naltrexone can trigger withdrawal.