Naltrexone is an FDA-approved medication that blocks opioid receptors in the brain to reduce cravings for opioids and alcohol. Telehealth now makes it possible to get a naltrexone prescription online from a licensed clinician without traveling to a clinic for every visit.
Here at Porch Light Health, we understand that getting started with medication-assisted treatment can feel uncertain, especially when you’re not sure whether care is available close to home. This article walks you through how naltrexone works, who can prescribe it online, and what to expect when starting treatment through our network of clinics, mobile sites, and virtual visits across Colorado and New Mexico.
Naltrexone is an opioid receptor antagonist available as a daily oral tablet and a monthly extended-release injectable. It occupies opioid receptors to block the euphoric effects of opioids and blunt the reward signals that reinforce heavy drinking. Our clinicians can evaluate whether naltrexone is appropriate for your situation and coordinate the prescription alongside ongoing care.
For opioid use disorder (OUD), naltrexone can only be started after confirmed opioid abstinence, usually 7 to 14 days, to avoid precipitated withdrawal. For alcohol use disorder (AUD), it can be started without prior opioid abstinence, though a physician assessment is still required. Both conditions benefit from combining medication with counseling and follow-up monitoring.
Naltrexone is a prescription-only medication in the United States, available as oral tablets and as an extended-release injectable. Any licensed clinician authorized to write prescriptions, including MDs, DOs, nurse practitioners, and physician assistants, may prescribe it depending on their state scope of practice. A clinical evaluation and documentation of suitability are required before any provider prescribes naltrexone therapy.
| Feature | Naltrexone | Methadone | Buprenorphine (Suboxone) |
| Drug class | Opioid antagonist | Opioid agonist | Partial opioid agonist |
| Dispensing requirement | Standard pharmacy or mail | Certified OTP clinic only | Office-based, no special clinic |
| Telehealth prescribing | Yes (oral formulation) | No | Yes (post-2023 rule change) |
| Opioid abstinence required | Yes, 7 to 14 days | No | No (buprenorphine-naloxone) |
| Formulations | Daily tablet or monthly injection | Daily liquid at clinic | Film, tablet, or monthly injection |
| Alcohol use disorder approved | Yes | No | No |
Naltrexone’s flexibility with telehealth prescribing and standard pharmacy dispensing makes it more accessible than the clinic-restricted alternatives. If you’re weighing naltrexone against buprenorphine- or methadone-based treatment, the differences in dispensing requirements and opioid abstinence rules are often the deciding factors.
Clinicians routinely prescribe naltrexone for both AUD and OUD after a virtual clinical assessment. SAMHSA telehealth guidance supports telemedicine for substance use disorder medications, though state medical board rules can limit availability by location.
If you want to start with a virtual outpatient visit, we can confirm whether your state’s prescribing rules allow remote care before your first appointment.
State-specific limits apply. Ask your telehealth provider about local prescribing rules and whether any in-person step is required before treatment begins.
Any state-licensed clinician may prescribe naltrexone within their scope of practice. This includes MDs, DOs, addiction-medicine specialists, nurse practitioners, and physician assistants. A CMS guidance clarifies that no special DEA registration or clinic certification is required to prescribe naltrexone for either OUD or AUD.
Clinicians typically refer patients with pregnancy, unmanaged liver disease, complex psychiatric conditions, or treatment-resistant cases to addiction-medicine specialists or multidisciplinary teams. This supports coordinated medication management alongside counseling and ongoing monitoring. Our behavioral health services team works alongside prescribers to support that coordination.
Begin by confirming telemedicine availability and insurance acceptance with your chosen clinic or provider. For many people, the first step is an online intake collecting ID, medication lists, and past treatment history so your care team can move efficiently. Find a location near you using our clinic finder.
You’ll complete a brief online intake that typically takes 10 to 30 minutes. Have your ID, current medications, any past addiction treatment records, and insurance card ready to speed registration.
The clinician conducts a virtual assessment that screens for recent opioid use. Starting naltrexone too soon after opioid use can trigger precipitated withdrawal, so the timing review is a clinical safety step, not a barrier. A JAMA Network study outlines how timing affects safety and initiation protocols.
Your provider may order baseline liver function tests before prescribing. Typical lab turnaround is one to three days, though timing varies by lab and location.
Oral tablets can be sent to a local pharmacy or delivered by mail. The injectable requires an in-person clinic visit for administration.
Plan follow-up visits within the first month for side-effect checks, counseling referrals, and any recommended toxicology monitoring. For help finding a nearby appointment, visit our telehealth services page or call (866) 394-6123.
Oral naltrexone, the monthly injectable (Vivitrol), and other formulations differ mainly by dosing frequency and how they’re delivered.
| Formulation | Standard dose | How dispensed | Telehealth prescribing | Notes |
| Generic oral (naltrexone HCl) | 50 mg daily | Any retail or mail pharmacy | Yes, where state rules allow | Most affordable option; requires daily adherence |
| Brand oral (ReVia) | 50 mg daily | Retail pharmacy | Yes, where state rules allow | Same mechanism as generic; typically higher cost |
| Extended-release injectable (Vivitrol) | 380 mg, once monthly | In-clinic injection by trained staff | Prescription via telehealth; injection in clinic | Steady levels; removes daily adherence requirement |
| Low-dose naltrexone (LDN) | 1.5-4.5 mg (off-label) | Compounding pharmacy | Off-label; varies by prescriber | Emerging protocols; not FDA-approved for OUD/AUD at these doses |
| Implant | Variable (surgical placement) | Specialty or research center only | No | Uncommon; rarely covered by insurance |
Oral naltrexone is often prescribed via telemedicine where state rules allow and dispensed through retail or mail pharmacies. Injectable naltrexone must be administered in clinic; it isn’t designed for home delivery. For specifics on Vivitrol dosing, see the FDA label for Vivitrol.
Naltrexone commonly causes nausea, headache, and fatigue, particularly in the first one to two weeks of use. It can rarely raise liver enzymes; baseline and periodic liver monitoring are recommended when indicated. A clinical review via StatPearls covers naltrexone’s pharmacology and risk profile in detail.
Clinicians reduce precipitated withdrawal risk by taking a careful history and using urine drug screening. In some settings, clinicians use monitored naloxone challenge testing or low-dose opioid exposure to confirm abstinence before initiating naltrexone.
Clinicians prefer non-opioid analgesics or regional anesthesia for planned procedures in patients taking naltrexone. For unavoidable opioid pain management, teams may temporarily hold naltrexone under specialist oversight and document a clear pain plan before proceeding.
Use in pregnancy or breastfeeding is limited and requires consultation with obstetrics and addiction-medicine specialists. If pregnancy is possible, a pregnancy test is typically obtained before starting. Our treatment during pregnancy program supports this kind of coordinated care.
Naltrexone reduces heavy drinking by blocking opioid receptors that reinforce alcohol’s rewarding effects. Clinical reviews from the National Library of Medicine found that it lowers relapse to heavy drinking during treatment. Effectiveness depends on adherence, motivation, and access to counseling, so medication is typically most effective when combined with behavioral support.
The main treatment goals are:
Common prescribing approaches for alcohol use disorder include daily oral naltrexone at 50 mg or targeted dosing using the Sinclair Method. You may notice benefits within two to four weeks. Combining medication with counseling or mutual-help groups tends to improve outcomes and retention.
The Sinclair Method uses naltrexone taken one to two hours before drinking, so alcohol’s rewarding effects are progressively reduced and drinking gradually declines over weeks or months. This approach may suit motivated adults with heavy drinking who prefer a harm-reduction strategy over immediate abstinence.
A 2023 systematic review published in JAMA that included 118 clinical trials and nearly 21,000 participants supports oral naltrexone at 50 mg per day as a first-line option for alcohol use disorder, reporting lower rates of return to heavy drinking compared with placebo.
Prescribing naltrexone via telehealth for the Sinclair Method requires remote screening for liver disease and opioid use, informed consent, and scheduled follow-ups. Toxicology or in-person testing may be arranged if clinically indicated.
The Sinclair Method targets drinking occasions by taking medication before planned drinking. Daily maintenance prescribing provides continuous medication to reduce relapse risk and is typically paired with broader monitoring and psychosocial support. Choosing between approaches depends on your goals, medical history, and your clinician’s guidance.
Generic oral naltrexone typically costs approximately $30 to $80 per month without insurance, based on current pharmacy pricing data. The extended-release injectable (Vivitrol) may cost $1,500 or more per dose without coverage, and many insurers require prior authorization.
| Cost item | Without insurance | With Medicaid/Medicare | With commercial insurance |
| Generic oral naltrexone (30-day supply) | $30-$80 | Often $0-$10 copay | Often $0-$30 copay |
| Vivitrol injection (per dose) | $1,500+ | Covered; prior authorization may apply | Specialty tier; PA often required |
| Telehealth initial assessment | $50-$150 per visit | Covered by most Medicaid plans | Varies by plan |
| Initial lab work (liver function, UDS) | $50-$200 | Generally covered | Often covered; deductible may apply |
| Vivitrol manufacturer copay card | N/A | Not typically applicable | Reduces commercial copay to $0-$25 per month |
We accept Medicaid, Medicare, Anthem Blue Cross Blue Shield, UnitedHealthcare, Humana, Cigna, and Kaiser Permanente. Manufacturer copay cards and patient assistance programs can reduce injectable costs significantly. Call (866) 394-6123 to confirm your coverage before your first visit.
Telehealth clinics must follow HIPAA security requirements including administrative, physical, and technical safeguards. HHS explains HIPAA security requirements in detail. Telehealth platforms should use encryption and role-based access; ask which platform your provider uses before your visit.
Prescriptions can be sent to a local pharmacy for pickup, delivered by pharmacy mail, or administered in clinic. If you want discreet billing or unmarked packaging, ask your care team upfront. You have a HIPAA right to access your visit notes and prescription records at any time.
For safety, clinicians document a treatment plan, schedule follow-ups, and arrange any needed lab work at or before the first prescription. The FDA recommends baseline liver enzyme testing and periodic monitoring when clinically indicated.
Moving from oral tablets to the injectable requires documented opioid abstinence, explicit consent, and a clinician-led transition plan covering timing and injection logistics. If you develop severe side effects or signs of withdrawal, seek in-person or emergency care immediately.
Rural and frontier patients often face the steepest barriers to consistent medication-assisted treatment. Distance to the nearest clinic, limited transportation, and variable broadband coverage can all interrupt care before it takes hold. Our network addresses these barriers through a combination of clinic locations, medical mobile sites, and telehealth services that work together rather than separately.
A 2025 study evaluating telehealth versus office-based MAT found no statistically significant difference in retention rates between the two modalities. This supports telehealth as a clinically sound option, not just a convenience.
For patients in communities where the nearest clinic is more than an hour away, virtual starts and mobile follow-up visits can make meaningful access to care possible.
Our mobile sites travel regular routes across northeastern, northwestern, central, southern, and western Colorado, bringing medication initiation and follow-up directly into frontier communities. Telehealth handles most assessments, prescriptions, and follow-up visits for patients with reliable internet access.
When an in-person visit is required, such as for a Vivitrol injection, our clinic network and mobile routes coordinate that step without disrupting the overall care plan.
This hub-and-spoke model means patients who start care via telehealth in rural New Mexico or Colorado can continue medication management without needing to drive to a city for every visit. We accept Medicaid, Medicare, and major commercial insurers, removing a common financial barrier alongside the geographic one.
Clinicians confirm no recent opioid use and typically check liver safety before starting naltrexone. You may be asked for a pregnancy test when applicable. Verifying recent opioid exposure helps avoid precipitated withdrawal and guides the choice between oral and extended-release injectable naltrexone.
You must be located in the state where your clinician is licensed at the time of the visit. Clinicians obtain informed telehealth consent. Prescriptions issued without meeting state licensure and consent requirements can be voided.
Expect baseline liver function tests to assess hepatotoxicity risk. A pregnancy test is routine for people who could become pregnant. Urine drug screening confirms recent substance use and informs safe initiation timing.
What is the difference between oral naltrexone and Vivitrol?
Oral naltrexone is a daily 50 mg tablet, while Vivitrol is an extended-release intramuscular injection given once every 28 to 30 days. Both block opioid receptors and are FDA-approved for AUD and OUD, but the injectable provides steady medication levels for a month and removes daily adherence as a barrier.
Can I get naltrexone if I recently used opioids?
Starting naltrexone while opioids are still active can cause sudden, severe precipitated withdrawal. Clinicians typically require 7 to 14 days of confirmed opioid abstinence, verified by history and often urine testing, before initiating treatment. The FDA includes a specific warning about this risk in the naltrexone prescribing information.
Do I need lab tests before starting naltrexone?
Many clinicians request baseline liver function tests because naltrexone can raise liver enzymes in some patients. A pregnancy test is often obtained for those who could become pregnant. If labs are normal and there are no other contraindications, clinicians commonly start treatment and monitor periodically.
Will my insurance cover naltrexone?
Medicaid and Medicare frequently cover oral naltrexone, and many plans cover Vivitrol with prior authorization. Commercial insurer coverage varies; copay assistance and manufacturer programs can reduce out-of-pocket costs significantly. We verify benefits and help with prior authorization when needed, so call (866) 394-6123 to confirm your coverage before your first visit.
Can pregnant or breastfeeding people take naltrexone?
Safety data in pregnancy and breastfeeding are limited. Most clinicians weigh potential benefits and risks carefully and often recommend alternative approaches or specialist consultation. Our treatment during pregnancy team can discuss options and coordinate specialist input when needed.
How long until I notice benefits for alcohol cravings?
Many people experience reduced craving or less rewarding effects from alcohol within days to a few weeks of consistent dosing. Measurable reductions in heavy drinking are commonly reported in clinical studies over weeks to months. Combining medication with counseling or behavioral strategies tends to improve outcomes and support early changes.
Can telehealth providers arrange the Vivitrol injection?
Telehealth clinicians can evaluate and prescribe Vivitrol, then coordinate a local clinic or partner site for the injection. If an in-clinic visit is needed, our care team will help arrange the appointment and confirm insurance coverage for the administration.
Is the Sinclair Method supervised online?
Online supervision typically includes an initial assessment, clear instruction on timing and dose, scheduled check-ins to review drinking patterns and side effects, and access to counseling resources. Clinicians set safety rules, monitor progress, and adjust the plan as needed.
If you’re considering naltrexone, the next step is a clinical assessment to confirm it’s appropriate for your situation. During a visit, a licensed clinician will review your medical history, screen for recent opioid exposure, arrange any needed labs or injection appointments, and discuss costs and follow-up so you leave with a clear, safe plan.
We offer telehealth visits, in-person clinic appointments, and mobile treatment across Colorado and New Mexico. Visit our Get Help Now page to start intake, or call (866) 394-6123 to speak with our team.
