The
Bluefield Clinic
Alcohol Recovery
Why Didn't Naltrexone Work For You?
Firstly, you are not alone
If you are unsure about naltrexone, or you’ve already tried naltrexone and it didn’t seem to make a difference, you’re not alone.
Many people are prescribed naltrexone expecting it will quickly reduce cravings or stop their drinking.
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When that doesn’t happen, it can feel disappointing - especially when you’ve taken a proactive step to make change.
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The reality is that naltrexone is an effective treatment, but outcomes depend heavily on how it is used and the context in which it is prescribed.
Five common reasons why naltrexone may not work
1. Timing and dosing may not have been optimal
​How and when naltrexone is taken can significantly influence effectiveness:
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Some people are prescribed daily dosing
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Others benefit from targeted dosing (TSM), taken 1–2 hours before drinking.​
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If timing is inconsistent or too late, the medication may appear ineffective.
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​​2. Expectations may not match how naltrexone works
Naltrexone:
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does not prevent intoxication
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does not lower blood alcohol concentration
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does not treat withdrawal​
Its primary role is to reduce the rewarding effects of alcohol over time. ​This means results are typically gradual rather than immediate.
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​​3. Lack of psychological or behavioural support
​Medication alone often isn’t enough. Alcohol use is influenced by:
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habits and routines
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emotional triggers
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environmental factors.
Without addressing these, change can be limited—even with medication.
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​​​4. Side effects may have interfered
​Some people experience:
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nausea
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headaches
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fatigue
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dizziness
These are usually mild and often transient but can reduce adherence if not managed properly.
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​​​​5. Individual biological differences
​Research suggests that genetic and neurobiological differences can influence response to naltrexone.
Some people respond strongly, while others notice little effect.