Some of us, probably most of us, have a tendency to do a little too much of something at one point or another. Shopping. Drinking. Eating. Whatever the habit is, there is often that immediate reward followed by the part that feels far less satisfying.
Personally, I have a MAJOR sweet tooth. And I don't mean a piece of candy here or there. I mean I could easily take down an entire Halloween-size bag of candy without much trouble. The cycle afterward of feeling like I overdid it, criticizing myself and wondering why I couldn't just stop is never worth the indulgence.
That cycle is exactly what led me to ask my doctor about a medication called naltrexone — an opioid-receptor blocker best known for treating alcohol and opioid dependence, which some doctors also prescribe off-label to help patients like me get a handle on cravings.
What I have personally noticed is that it creates a little buffer between the urge and actually wanting more.
I recently saw Dr. Messer, a physician who has treated me for a while now, and she explained that there is an actual brain-reward component behind some of these behaviors before telling me about naltrexone.
Naltrexone is an opioid-receptor blocker that was originally approved to treat opioid dependence and was later approved for alcohol dependence. It can reduce some of the reward and craving associated with alcohol, which is why it is sometimes used to help people drink less. It is also used off-label in other areas involving cravings or compulsive behavior, although the evidence there is much more limited.
In my case, Dr. Messer prescribed it as a low-dose pill I take as needed — specifically on the evenings when I know I'm more likely to overdo it, rather than every single day. What I have personally noticed is that it creates a little buffer between the urge and actually wanting more.
The biggest difference for me has been late-night eating and sugar. I can honestly say there have been nights when I would normally have gone straight for the candy and just kept going, and instead I simply…didn't really want it.
That has been fascinating to me because it made me realize how much of what I had always labeled as "lack of self-control" may also involve very real reward pathways in the brain.
I wish I had known about this 20 years ago. It may have saved me a lot of unnecessary self-criticism.
This is obviously not a medication for everyone, and it has real contraindications and possible side effects, so it is something to discuss with your own doctor before trying it. It also blocks opioid medications, which is particularly important for anyone who might need those for pain management or anesthesia.
But for me, it has quietly changed a habit I'd spent years fighting with willpower alone — proof, at least in my own experience, that some cravings are chemistry as much as choice.
Has anyone else heard of naltrexone being used this way? I'd genuinely love to compare notes.