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Drinking on Vivitrol: Can You Combine It with Alcohol?

alcohol-and-vivitrolVivitrol is the brand name for the injectable and extended-release form of the opiate antagonist medication naltrexone. The best known brand name for naltrexone is ReVia, the pill form of the immediate-release version of the drug. The extended-release form allows an individual to take it fewer times during the week; with the pill form, it must be taken daily.

Naltrexone has a mechanism of action where it immediately binds to the opioid receptors in the brain, thereby occupying these receptors and reducing cravings for drugs and alcohol. This allows the drug to be useful in the treatment of certain types of substance use disorders.

There is essentially no abuse potential for naltrexone as it does not produce euphoria and its use does not result in any other types of desired psychoactive effects that drug abusers seek. The drug is not listed as a controlled substance; however, it does require a prescription from a physician.

Use of Alcohol and Vivitrol in Conjunction

There have been few identified serious dangers associated with mixing alcohol and naltrexone in any form. Most of the issues associated with use of the drug come from potential side effects that it rarely produces, and some of these side effects and the potential dangers associated with them may be increased in people who have suffered serious physical issues as a result of long term alcohol abuse (see below).

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Food and Drug Administration (FDA) have released information based on the results of empirical research studies that indicate that the use of alcohol and Vivitrol together will result in certain effects in some people:

  • Naltrexone products do not reduce the effects that are associated with use of alcohol, such as physical issues with reflexes and coordination and the typical effects that alcohol has on mental function.
  • Using naltrexone does not result in an individual being able to drink more alcohol than normal; naltrexone does not increase one’s tolerance for alcohol.
  • Naltrexone has been demonstrated to reduce cravings or urges to continue drinking alcohol once one has started drinking.
  • The effects of naltrexone appear to be successful in reducing overall intake of alcohol.
  • Naltrexone is useful in reducing cravings and the amount of alcohol that one drinks, but it must be used in conjunction with therapy in order for it to be fully effective in recovery from an alcohol use disorder.

Even though naltrexone was developed to decrease cravings in individuals with opiate use disorders (e.g., heroin abuse, the abuse of prescription narcotic pain medications, etc.), it also appears to be useful in helping individuals with alcohol abuse issues decrease their intake of alcohol.

However, the research has indicated that using naltrexone does not result in:

  • An individual becoming abstinent from alcohol use
  • The production of negative effects associated with alcohol use that would dissuade the person from continuing to drink alcohol (e.g., nausea, vomiting, etc.)
  • “Curing” a person of their alcohol use disorder
  • Reducing the symptoms or effects of alcohol withdrawal
  • An effective replacement for standard treatments for individuals with alcohol use disorders
  • Counteracting the short-term and long-term effects of having an alcohol use disorder (e.g., issues at work, with physical health, with cognition, etc.)

The utility of Vivitrol and other naltrexone products is the ability of the drug to reduce cravings for alcohol and to result in a reduction in the amount of alcohol one drinks once one has started drinking. Using naltrexone alone does not result in abstinence from alcohol. Individuals with moderate to severe alcohol use disorders who are having difficulties remaining abstinent from alcohol may find it reduces their cravings for alcohol, but they still need to become involved in a formal alcohol use disorder treatment program in order to increase their chances of a successful recovery.

There have been several different approaches that have attempted to increase the effectiveness of the drug in reducing cravings for alcohol and alcohol intake in individuals who begin drinking after using the drug. For instance, there is limited evidence from a research study that has indicated that if a person takes the pill form of the drug about an hour before they begin to use alcohol, they tend to drink alcohol in lesser amounts than they normally would.

However, the standard approach used by most physicians who prescribe naltrexone products in pill form is to instruct the individual to take it early in the morning in an attempt to reduce cravings for alcohol throughout the day. Using the injectable and extended-release form (Vivitrol) would also satisfy these conditions and should increase the potential effectiveness of naltrexone. However, the research does not support the use of naltrexone alone to treat individuals with alcohol use disorders, nor does the research support the idea that using naltrexone products such as Vivitrol will produce abstinence in individuals with alcohol abuse issues. In addition, most sources, like the FDA, suggest that an individual should be abstinent from alcohol for at least a week to 10 days before they take naltrexone products like Vivitrol in order for it to be effective in reducing cravings for alcohol and reducing the amount of alcohol one consumes.

 Vivitrol and other drugs containing naltrexone have relatively few side effects, and the drug is considered to be safe to use in most individuals; however, every medication or drug has a side effect profile.

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Naltrexone use may result in certain side effects:

  • Nausea, diarrhea, and stomach cramps are the most common side effects.
  • Headache, muscle cramps, or muscle stiffness may occur in some people.
  • Some individuals may have issues with insomnia or hypersomnia (sleeping too much).
  • Some individuals may experience jitteriness, anxiety, or irritability.
  • People who are actively using opiate drugs or women who are pregnant should not use products that contain naltrexone.
  • Naltrexone use may produce hepatitis or liver damage, and people with either of these conditions as a result of alcohol abuse are at increased risk for serious liver complications if they use Vivitrol.


Vivitrol is the extended-release form of the opiate antagonist naltrexone. It can reduce alcohol intake and alcohol cravings in some individuals, and it is often prescribed for that purpose. Drinking alcohol while taking Vivitrol is not associated with any significant risks other than the normal side effect profile. Some sources suggest that Vivitrol should be taken before one plans to drink alcohol in order to reduce overall alcohol intake.

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About The Contributor
Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of River Oaks Treatment is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed... Read More