Old drug, new tricks: Low-dose naltrexone as treatment for chronic pain

When you suffer from chronic pain it effects everything in your life – how you sleep, your mood, ability to work and social life. Low-dose naltrexone has been around for decades. Recently, it is used more wide-spread as a treatment to help people in pain regain their quality of life.

Low-dose naltrexone has unexpected benefits

Naltrexone is FDA-approved treatment for drug and alcohol addiction. It partially blocks opioid receptors, which encourages your body to increase hormone production to reduce pain and enhance your mood.

People who suffer from autoimmune conditions like fibromyalgia, multiple sclerosis and a variety of other issues could increase function and have less pain when taking the low dose of naltrexone.

“At first, people are concerned that I’m recommending a medication that when Googled doesn’t match what they are being treated for,” said Kelly Zopfi, Marshfield Clinic Health System pain management nurse practitioner. “Oftentimes in health care we find alternative and sometimes better uses for drugs. If it’s low risk with a high impact, we consider doing a trial.”

Treating the whole body

Patients start at the lowest dose and if their body responds well, they step up the dosage over four weeks to the optimal level.

“Side effects are minute, potentially vivid dreams, mood might be off and nausea,” Zopfi said.

These side effects typically lessen after several weeks, but Zopfi encourages patients to connect with their health care provider during this time to talk about what they are experiencing to make adjustments as needed.

Chronic pain happens over time and we cannot expect medication to be a quick fix. Lifestyle choices really drive how we feel. Zopfi encourages exercise and making healthy dietary choices. “Our gut makes many of the hormones we use to feel good. If we put junk in, expect junk out. Food is a building block that impacts how those chemicals in your stomach work,” she said.

Timing is everything

When taken before bed, low-dose naltrexone blocks some opioid receptor sites and signals the body to increase endorphin production. This happens while you’re sleeping so you feel less pain during the day. If you have pain at night you and your provider create a schedule that helps the medication work effectively for you.

“Our goal is to treat patients using all the tools available, while being compassionate and realistic about our options and limits to help patients find best quality of life,” Zopfi said.

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