Alcohol Use Disorder (Naltrexone Treatment)

Overview

Naltrexone is the most-studied medication for alcohol use disorder. It blocks the opioid receptors that reward drinking, so alcohol becomes less reinforcing and cravings fade — typically over 4–12 weeks. Two dosing strategies work: daily oral naltrexone 50 mg for abstinence, or the Sinclair Method (take 50 mg one hour before drinking) for gradual reduction. Naltrexone is not addictive, not a controlled substance, and does not cause a disulfiram-like reaction. Clindle screens for liver disease, orders baseline LFTs, prescribes naltrexone the same visit when appropriate, and coordinates injectable Vivitrol referrals for patients who prefer monthly dosing.