Substance guides

Can you drink on naltrexone? How the medication works

Published October 25, 2025 · 6 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Unlike Antabuse, naltrexone does not make you sick if you drink. Instead, it reduces the pleasure from alcohol, gradually weakening the reward association.

What happens when you drink on naltrexone

You can still drink physically. But the buzz is diminished. The euphoria is reduced. The urge to keep drinking after the first drink is weaker. Over time, this pharmacological extinction reduces the desire to drink.

The Sinclair Method

TSM specifically involves taking naltrexone 1 hour before drinking (not daily). The goal is to drink on the medication, allowing the blocked reward to gradually extinguish the learned drinking behavior. Studies show 78% reduction in drinking over 3-4 months.

Important distinctions

Naltrexone does not make you sick (that is Antabuse). Naltrexone does not get you high. Naltrexone does not cause dependence. Naltrexone blocks the opioid component of alcohol's reward, not all effects.

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

Can you still drink alcohol on naltrexone?

Yes, physically. But alcohol produces less pleasure. This is intentional and is how the medication works to reduce drinking.

Will naltrexone make me sick if I drink?

No. That is Antabuse (disulfiram). Naltrexone reduces pleasure from drinking but does not cause a physical reaction.

What is the Sinclair Method?

Taking naltrexone 1 hour before drinking to block reward and gradually extinguish the desire to drink. Studies show 78% reduction in drinking.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.