Is it possible that naltrexone tablets could help people kick their speed habit?
Naltrexone is an opioid blocker that comes in the form of an oral tablet. It has been approved by the FDA since the 90s and is available now as an inexpensive generic. Naltrexone is approved for treating alcoholism and opioid addiction. It is also available as a monthly injection named Vivitrol. Recently, there have been some preliminary studies on the possibility of using this drug to treat addiction to stimulants such as methamphetamine, amphetamine, and cocaine. The results for some patients have been promising.
How does naltrexone help with alcohol use disorder?
Why does blocking opioid receptors in the brain help a person to quit drinking alcohol? One theory, which is connected to The Sinclair Method of quitting drinking, is that blocking the opioid receptors stops endorphins from binding to them. This, in turn, causes the patient to not get a reinforcing “reward” in their brain associated with alcohol intake. Endorphins are the brain’s way of helping us to develop good habits, like eating food and getting exercise. Unfortunately, this natural reward system in our central nervous system can get out of control.
The science of unlearning a bad habit.
In the early 20th century, Ivan Pavlov, the first Russian to win a Nobel prize, demonstrated how this endorphin-based system works with his famous experiment of ringing a bell to cause dogs to salivate. What many people do not know about Pavlov’s research is that he also demonstrated that the process works in reverse as well. Removing the reward causes the behavior to diminish over time. Dr. Sinclair based his work with naltrexone for alcoholism on Pavlov’s theories and called it “pharmacological extinction.”
Why are doctors not prescribing naltrexone for meth addiction?
Many doctors prescribe medication by following FDA guidelines. This means that if the FDA has not approved a drug for a particular use, it will not be widely used. However, doctors are allowed to prescribe medications “off-label,” meaning that they can prescribe a drug for a particular purpose, even if it has not been approved for that purpose. This is a good thing because there are reasons why medications do not get FDA approval also if they are safe and effective for a particular condition. For example, if a drug is generic, it is not likely that any pharmaceutical company will spend the money to do the required research for additional FDA approvals for other conditions. When it comes to using naltrexone for methamphetamine or cocaine addiction, studies are still in early stages, and naltrexone is already an inexpensive and readily available generic.
Should doctors be offering naltrexone for meth and cocaine addiction?
Naltrexone is a very safe drug. There is a movement to file with the FDA to make naltrexone an over-the-counter medication. Doctors should consider providing a naltrexone prescription when the benefits outweigh the risks. In the case of naltrexone, the risks are few. I believe that it is worth it to give patients a chance of trying naltrexone for speed addiction to see if it can help. At this time, there is no known effective medical treatment for stimulant addiction otherwise. If naltrexone can help, even a little bit, it will be worth it to provide the patient with this extra help in quitting their habit.
When alcohol acts as a gateway drug.
In many cases, people who use cocaine or other stimulant drugs report that they often only use these drugs after consuming alcohol. This is an exciting finding because it opens up the possibility that if a doctor can help the patient to reduce or eliminate alcohol use, they may also find it easier to quit methamphetamine or cocaine use. Since we know that naltrexone can be very effective in helping patients to reduce and eliminate alcohol intake, we can certainly justify prescribing naltrexone in these cases. In fact, this would be an FDA approved use of naltrexone, since it would be primarily aimed at stopping alcohol intake.
Further research is needed.
Unfortunately, as we focus on addressing the opioid crisis, methamphetamine use is on the rise. There has been a sharp increase in the rate of methamphetamine use and overdose. There must be more research on naltrexone and other drugs that show promise in treating cocaine and methamphetamine addiction. Additionally, it is also essential to explore psychotherapy treatments, as well. We must prepare for this new and growing drug epidemic before it gets out of hand.