What the anti-alcohol injection is and how naltrexone works
People who come to us for the anti-alcohol injection usually have hours of online reading behind them and one recurring worry: whether it is safe and whether it works at all. Before we break the whole process into stages, it is worth setting the basics straight, because two different medicines hide online under a single label. The injection we give is extended-release naltrexone, known as Vivitrol. It is not disulfiram, the substance in the well-known implant.
How naltrexone acts on alcohol craving
The mechanism here is different from the implant. Naltrexone belongs to the opioid receptor antagonists, meaning it blocks the places in the brain responsible for the reward after alcohol. When drinking stops unlocking pleasure, the urge for the next glass fades over time, and it is precisely that urge, called alcohol craving, that most often breaks resolutions. Importantly, the medicine itself sets off no violent symptoms after a drink and does not lead to addiction.
Why a single naltrexone dose lasts a month
That one administration lasts a month is decided by the form of the medicine. Here naltrexone is trapped in microscopic beads, microspheres, from which it seeps out slowly over the following weeks. This takes off your plate the daily ritual of swallowing a tablet and the temptation to skip it in a weaker moment.
The injection as part of treatment, not a separate course
It has to be said plainly that naltrexone is not a standalone course, and the manufacturer's information suggests nothing of the sort. Its greatest value is as part of a wider plan: alongside psychotherapy, the support of those around you and work on what pushes you toward drinking. That is why we tell the patient right at the start that the injection opens the door, but walking through it is something you have to do yourself, in therapy.
From the first phone call to the injection: the step-by-step course in Poznań
The most common question at the first conversation is a simple one: where to even begin. I will lay out the whole road in order, because the naltrexone injection is not a single jab but a multi-stage process spread over a few weeks. Whoever understands the order of the steps goes through it more calmly.
Step one: the phone call and medical qualification
Everything starts with a phone call and booking a qualifying visit at our Poznań clinic. At that visit the doctor gathers the drinking history, earlier attempts at treatment, chronic illnesses and the full list of medicines. One question is decisive: whether the patient takes any opioids at all, because naltrexone and opioids rule each other out. Without that conversation there is no administration, however pressing the timing.
Step two: when a detox is needed first
After qualification the doctor assesses whether anything stands in the way of giving the medicine safely. If the patient is in the middle of a binge or in active withdrawal, they first have to be safely detoxed, so we start with alcohol detox in Poznań and come back to qualification later.
Step three: giving the injection and the following doses
Once the doctor gives the green light, we book the date of administration, and then we plan the following doses every 4 weeks. The whole rhythm is set in advance, so that the next dose is ready before the previous one stops working.
The day of administration, the four-week rhythm and how long injection treatment lasts
The jab itself is a matter of a moment, but there is more going on around it. Patients usually ask about two things: what the day of administration looks like and how many months the whole treatment will take. I will answer in turn.
How the naltrexone injection is given
On the day of the injection the doctor first makes sure nothing stands in the way: that the patient has not taken opioids recently, has no jaundice or withdrawal symptoms and is not preparing for a procedure that would require opioid painkillers. Meanwhile the preparation comes up to room temperature after being taken out of the fridge. The 380 mg dose is placed deep into the gluteal muscle, and each successive administration is given in the opposite buttock to the previous one.
How many weeks one injection works
A single dose releases over roughly 4 weeks, which is why administrations are planned at monthly intervals. Towards the end of the cycle the medicine works more weakly, which is a further reason not to delay the next injection. If the date slips, the following dose is given as soon as possible, but no sooner than 4 weeks later and no larger than 380 mg.
How long treatment lasts and what studies say
There is no single answer to the question of how long treatment lasts. The manufacturer's information gives neither a minimum nor a maximum, and scientific societies most often point to a period no shorter than six months. The rest depends on the course: on the abstinence maintained and on how the body tolerates the successive doses. The results of studies are worth reading calmly. In Garbutt's much-discussed study published in JAMA in 2005, the group receiving 380 mg had about 25 percent fewer days of heavy drinking than the placebo group. A pooled analysis of seven studies from 2022, in turn, suggested a greater benefit from treatment lasting longer than three months, though its authors themselves note that the data cover at most six months. This shows a direction, not a guarantee, because naltrexone gives the most when combined with therapy.
The safety of naltrexone, contraindications and loss of tolerance
Before the first administration takes place, the patient hears from us the full list of risks. Naltrexone is a medicine that has been known and used for years, but it is no sweet: it has limits that must not be crossed at qualification. I go over the most important of them below.
Loss of opioid tolerance, the most important warning
The most serious risk is connected with opioids. Since naltrexone occupies the opioid receptors, during treatment the body loses the habit of these substances and its tolerance to them, and this weakened tolerance persists even after the last dose. Trying to break through the blockade with a larger amount of an opioid, or going back to the dose from before therapy, then risks respiratory arrest and, in the worst case, death. For this reason, for at least 30 days after the last injection no opioid medicines may be taken, and the patient should carry information about the treatment in case of a sudden operation or injury.
Naltrexone side effects: the injection site, the liver and mood
The vast majority of adverse effects are mild and pass on their own: nausea, headache, fatigue, muscle and joint aches. Around the injection site there can be pain, hardening or swelling, and quite exceptionally a change that a surgeon has to examine. Two things we watch more closely than the rest. The first is the liver: jaundice, dark urine or abdominal pain call for prompt contact with a doctor. The second is mood, because in people who drink the risk of it worsening is raised.
Who cannot receive the injection
Beyond this there is a closed list of absolute contraindications. The injection will not be given to a person who:
- takes opioids in any form, including opioid painkillers and substitution treatment,
- is in active withdrawal,
- is pregnant,
- has acute hepatitis or severe liver failure,
- is allergic to naltrexone.
A separate caution applies to a planned procedure using opioid painkillers. This list is exactly why qualification is not a formality with us, but a real safety filter.
Injection, implant or tablets: how the methods differ
Now that the patient knows the course and safety of the injection, there remains the question that sooner or later comes up: why this method in particular, and not the implant or tablets. Instead of listing them side by side, I will show how they differ in everyday use, because that usually settles the choice.
The implant deters, naltrexone fades the urge to drink
The deepest difference concerns what the medicine does at the moment of drinking. The disulfiram in the implant deters: after alcohol it provokes violent, dangerous symptoms, so a person does not drink for fear of the reaction. The naltrexone in the injection does nothing of the sort. It makes drinking stop giving its former pleasure, and the craving weakens over the weeks. Some are held more firmly by fear, others are closer to a calm fading of the urge.
How much daily attention the injection, implant and tablet need
The second matter is how often the method reminds you of itself day to day. The naltrexone tablet demands a decision every morning, because it works only when the patient actually takes it, and it is on the crisis day that it is easiest to drop. The implant is at the other pole: once placed, it works for many months before the subject of another procedure comes back. The injection keeps to the middle, because a single administration settles the matter of the medicine for a whole month, with no daily supervision and no surgical visit.
Who ultimately chooses the treatment method
There is no method that is good for everyone. The choice depends on the drinking history, coexisting illnesses, the medicines being taken and what matters most to the patient. That is why the method is chosen by the doctor together with the patient at qualification, after a calm weighing of all the pros and cons. Anyone leaning towards the aversive solution will find the details on the page about the alcohol implant in Poznań.
The realities of alcoholism treatment in Poznań and the naltrexone injection
The naltrexone injection does not exist in a vacuum. It is worth seeing it against the backdrop of what alcoholism treatment in Poznań looks like, because that explains why some patients look for a private, planned path.
How many people in Poznań face an alcohol problem
The scale can be seen in the city's estimates. According to the Municipal Programme for the Prevention and Solving of Alcohol Problems, adopted by a resolution of the Poznań City Council, the number of residents dependent on alcohol in 2024 could have reached about 10 thousand people, while those drinking harmfully and at risk were estimated at 25 to nearly 36 thousand. These are figures adopted for the purpose of planning the city's help, not a precise register, but they show well that the problem concerns a large part of the city.
What access to treatment in Poznań looks like
Public addiction treatment in Poznań rests, among other things, on a round-the-clock ward for treating alcohol withdrawal syndromes, to which a patient is admitted after prior qualification. The scale is considerable: in 2022, according to the city report, it admitted 404 people and provided more than 2,400 healthcare services. There are more therapeutic facilities in the city, but a visit in the public system usually means a wait of weeks. Private qualification for the injection shortens that first step.
Where in Poznań to book qualification for the injection
The first step is a phone call to 880 808 880 and booking qualification at our clinic at ul. Górki 17A. The injection is rarely the whole answer, which is why from the start we propose it together with addiction therapy in Poznań, and when the situation calls for it, also with broader alcoholism treatment in Poznań. We talk about the price after the visit, because it is made up of several separate items: the consultation, the cost of the medicine and its administration. Until we know the patient's situation, any figure given upfront would be guesswork.
