How To Start Naltrexone: Your First Steps Toward Change

Naltrexone is a safe, FDA-approved medication that can help you drink less, quit entirely, or regain control after feeling like alcohol has the upper hand. Whether you’re looking to cut back or to quit, this quick start guide will walk you through how it works, how to take it, and how to get the most out of your first weeks.

How Naltrexone Works

When you drink alcohol, your brain releases endorphins, “feel-good” chemicals that reinforce the urge to keep drinking. Naltrexone blocks this effect, so alcohol no longer produces the same rewarding high.

Over time, naltrexone helps you take back control from alcohol, so you don’t feel compelled to keep drinking once you start. Importantly, naltrexone doesn’t make you sick if you drink, isn’t addictive, and doesn’t affect your ability to enjoy natural pleasures like food, exercise, or time with friends.

Two Common Ways to Take Naltrexone

There are two common ways to take naltrexone:

1. Daily Dosing (traditional, on-label use)

• How it works: one 50mg dose is taken at roughly the same time each day.
• Why some choose this approach: a daily dose provides steady coverage, which can reduce overall cravings without needing to plan ahead.
• Timing note: naltrexone is most active for about 4–8 hours and peaks 1–2 hours after you take it, so many people find it helpful to align the dose with the time of day when cravings are strongest.

2. Targeted Dosing (as-needed use, sometimes called The Sinclair Method or TSM)

• How it works: one 50 mg dose is taken 1–2 hours before drinking. On alcohol-free days, no dose is needed.
• Why some choose this approach: this method requires medication support only on drinking days and diminishes the rewarding effects of alcohol over time.

Both approaches have been shown to help reduce drinking. The best choice depends on your individual goals and drinking patterns, and is something to decide together with your clinician.

Choosing Your Approach

If you’re not sure which is best, think about:

• Your goal: Quitting altogether? Daily may be best. Cutting down? Targeted may be ideal.
• Your pattern: If you drink on impulse, daily dosing covers you. If you plan in advance, targeted works well.
• Your cravings: If you have strong urges on non-drinking days, daily dosing reduces overall cravings and still blocks alcohol’s effects if you do drink.

You can start with one method and adjust later as your goals evolve.

Getting Started: Tips & Timing

Start slowly if needed: if you’re worried about side effects, begin with half a tablet for a few days, then increase to the full dose.

Take with food: eating right before or after your dose can reduce nausea or stomach upset.

Hydrate: drink a full glass of water with your pill.

If nausea occurs, an over-the-counter motion sickness medication can be taken with naltrexone.

Plan your timing:

• Daily dosing: Take it at the same time each day, ideally 1 to 2 hours before your usual craving window or drinking time.
• Targeted dosing: Take it 1–2 hours before you expect to have your first drink.

Track your drinking: Use an app, journal, or calendar to record drinks, triggers, and cravings. This helps you see progress over time.

What to Expect in the First Few Weeks

In the beginning: some people notice fewer cravings for alcohol right away, while for others the change is more gradual.

The reality: naltrexone isn’t a “magic pill.” Many people see the biggest benefits after three to six months of consistent use. Experts recommend continuing naltrexone for at least one year if it is helping you to make progress toward your goals.

Common early side effects: mild nausea, headache, dizziness, or fatigue. These usually subside within a week or two.

Sleep changes: you might notice vivid dreams or restlessness at first, but as drinking decreases, most people find their sleep improves.

Frequently Asked Questions

Will I still get drunk? Yes. Alcohol will still impair coordination, judgment, and reaction time. What changes is the ability to control how much you drink.

Can I drink on naltrexone? Yes. Naltrexone helps you take control of your drinking. It lowers the urge to keep drinking once you start, making it easier to cut back or quit.

Will it help with withdrawal? No. Naltrexone doesn’t treat alcohol withdrawal symptoms. If you’re a heavy daily drinker, consult a healthcare provider before cutting back drastically. If you experience severe withdrawal symptoms after stopping or reducing alcohol use, you must seek emergency care right away.

Is it addictive? No. Naltrexone doesn’t cause a high, and you can stop without withdrawal symptoms.

Boosting Your Chances of Success

• Be consistent. Skipping the medication on drinking days slows and can even reverse progress.
• Set small goals. Celebrate fewer drinks, more alcohol-free days, or shorter drinking sessions.
• Pair it with behavioral changes. Mindfulness, new routines, and tracking your drinks can speed results. Your Oar Health coach can work with you to create a personalized plan that supports your goals and fits your lifestyle, giving you the best chance for lasting change.
• Use support. In addition to your Oar Health coach, consider peer support groups like

When to Reach Out to Your Medical Provider

• Side effects are severe or persist after a couple of weeks.
• You’re not noticing any change in your drinking after several months.
• If you have any health changes, have an upcoming surgical procedure, or start new medications (especially opioid-based painkillers).

Final Word

Starting naltrexone is more than just taking a pill. It’s choosing to change your relationship with alcohol. Whether you want to quit or simply drink less, the key is consistent use. For some, the shifts are fast; for others, they’re gradual but lasting. Give it time, track your progress, and lean on support when you need it.

You’re not just reducing drinks. You’re opening the door to better sleep, clearer mornings, and more control over your choices. That’s a powerful place to begin!