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by hn_user82179 1518 days ago
I'm currently on a naltrexone/wellbutrin combo. I started it to try to finally end an infinite binge/purge cycle I find myself stuck in (an eating disorder). I also have depression/insomnia and had been self-medicating with alcohol (really, I just drank to relax -> drank to fall asleep -> didn't fall asleep -> drank more). I wouldn't say it was a lot compared to what you think of when you think of an alcoholic but it definitely fell under the category of binge drinking nightly (~3 beers a night). I had reached a point where I figured it'd be good to stop (after reading about how easily one can develop a Thiamine deficiency) but found it... not easy. I could go a few days but living alone, wfh, etc made me really enjoy my post-work/before-bed beer ritual - it felt like the only thing distinguishing night and day.

The medication has helped all 3 issues, a lot. How much it's worked is incredible. I don't know how hard it would've been to stop alcohol without it, but I'm sure I would've failed more before succeeding. Honestly, I'm more impressed by how it's helped me manage my relationship with food. I've spent the last 15+ years obsessing over food. I still think about it far more than people without eating disorders, but my self-worth is not tied to whether or not I eat. I think my mood was better managed on my old antidepressant but things now feel... how I think "normal" is?

That said, I do need to get a medical bracelet of some sort. My doctor didn't mention exactly how naltrexone worked and it wasn't until I stumbled across /r/alcholism_medication that I realized that if I got hit by a car or had some other accident, was unconscious and administered opiates - they wouldn't work, and being on naltrexone could have harmful effects if I underwent emergency surgery if the medical personnel were unaware of my prescription.

1 comments

Probably good to have an alert bracelet, but if you were undergoing emergency surgery, the anesthetist would monitor close enough to know something is off and respond appropriately.
How? By upping the pain medication?
Pretty much. Naltrexone is a competitive antagonist against the opioid reception (u being the important one).

They would give the standard amount of opioid (say fentanyl) and if they don't see the desired response they'll up it. Eventually you can "out compete" the naltrexone for the opioid receptor and get an effect.

If they do give 2-3x the dose, they'll be sure to monitor closely after to make sure everything goes well.