Does Vivitrol help with cravings?

Medically reviewed by Sally Chao, MD. Last updated on May 2, 2025.

Official Answer by Drugs.com

Vivitrol (naltrexone) can help reduce opioid or alcohol cravings in people with an opioid or alcohol use disorder. It blocks the euphoric effects of opioids or alcohol, reduces cravings and helps to prevent relapse. It is administered as a once-monthly injection.

Research suggests that Vivitrol leads to a reduction in cravings within the first two to three weeks of treatment and continues to stave off cravings throughout treatment.

One clinical trial found that Vivitrol seemed to reduce self-reported opioid cravings more quickly than Suboxone (buprenorphine and naloxone), another drug used to prevent opioid relapse. However, after 24 weeks of treatment, both drugs were associated with similar levels of self-reported opioid cravings.
In another trial comparing Vivitrol and Suboxone, prior heroin users receiving Vivitrol had fewer heroin cravings and thoughts of heroin than those who took Suboxone.
A study of people being treated for alcohol dependence in an inpatient substance abuse program found that those who received Vivitrol saw their alcohol cravings dissipate more quickly than those who did not take Vivitrol.

However, some patients may experience cravings during treatment. If breakthrough cravings occur, a doctor may recommend getting Vivitrol injections once every three weeks instead of the standard four-week cycle. Cravings are more likely to return after discontinuing treatment with Vivitrol.

How Vivitrol curbs cravings is not fully understood. One potential explanation is that people are less likely to crave opioids or alcohol if they know that they will not feel their euphoric effects while taking Vivitrol.

References

American Society of Addiction Medicine (ASAM). National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. 2020. Available at: https://www.asam.org/docs/default-source/quality-science/npg-jam-supplement.pdf?sfvrsn=a00a52c2_2. [Accessed April 19, 2021].
Helstrom W, Blow F, Slaymaker V, et al. Reductions in Alcohol Craving Following Naltrexone Treatment for Heavy Drinking, Alcohol and Alcoholism. 2016;51 (5):562–566. https://doi.org/10.1093/alcalc/agw038
U.S. Food and Drug Administration (FDA). Vivitrol (naltrexone for extended-release injectable suspension). Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021897s015lbl.pdf. [Accessed April 19, 2021].
American Society of Addiction Medicine (ASAM). Ask the PCSS Expert: Does Evidence Show Naltrexone Reduces Cravings? December 15, 2015. Available at: https://www.asam.org/Quality-Science/publications/magazine/read/article/2015/12/15/ask-the-pcss-expert-does-evidence-show-naltrexone-reduces-cravings. [Accessed April 19, 2021].
Lee JD, Nunes EV, Novo P, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. The Lancet. 2017;391 (10118): 309 – 318. https://doi.org/10.1016/S0140-6736(17)32812-X
Tanum L, Solli KK, Latif Z, et al. Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence: A Randomized Clinical Noninferiority Trial. JAMA Psychiatry. 2017;74(12):1197–1205. doi: 10.1001/jamapsychiatry.2017.3206

What happens if you drink alcohol while taking naltrexone?

Naltrexone blocks the feelings of intoxication (the “buzz”) from alcohol when you drink it. This allows people with alcohol use disorder to lessen their drinking behaviors enough to stay in treatment, avoid relapses, and take their medication. Over time, cravings for alcohol will decrease. However, naltrexone will not prevent you from becoming impaired while drinking alcohol. Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol. Continue reading

What to avoid when taking naltrexone?

Do NOT take opiates, including heroin or other prescription or illegal opiates while using naltrexone. Taking opiates with naltrexone increases your risk for an overdose, coma and death. Do not use naltrexone if you are dependent on opioids or if you are experiencing opioid withdrawal symptoms. Naltrexone should not be used before you complete a medically-supervised opioid withdrawal lasting at least 7 to 14 days. Continue reading

Should I take naltrexone in the morning or at night?

The manufacturer does not specify if you should take naltrexone tablets in the morning or at night. Take naltrexone exactly as your doctor orders it. Many patients take their medication in the morning to help affirm their continued treatment success for either opioid use disorder or alcohol use disorder. Taking naltrexone tablets after a meal (for example: breakfast) may help to lessen any stomach side effects such as nausea or pain. Continue reading

Does Vivitrol help with cravings?

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What happens if you drink alcohol while taking naltrexone?

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