Using Naltrexone (Ldn) with Opioids and Opiates

Avoid the risk of Addiction
Safely Use Naltrexone (Ldn) with Opioids and Opiates

For a little history of how Naltrexone was first used and approved for help with alcohol and drugs, and how it was then discovered that low dose boosts the immune system see

While Naltrexone (Ntx) was developed to combat alcoholism and other addictions by blocking certain receptors in the body, it was found in lower doses (Low Dose Naltrexone - Ldn) to modulate the immune system and aid many people with pernicious diseases and conditions.

However it was widely believed one could not take Ntx while taking an opioid/opiate based pain reliever, even in the far lower doses (less than 5 mg) than those approved to treat addiction (50-200 mg), as Ntx blocked those receptors the opioid activated. There were some pretty ugly incidents where people tried to take the two (Ldn with an opioid) and either ended up in major discomfort/pain because the Ntx blocked the pain relieving opioid; or worse the person was unwittingly addicted to the opioid and the Ldn threw them into a horrific withdrawal. For those very valid reasons, the Ldn "community" (which is largely "self taught" and based outside the approved medical community) and the medical community itself VERY strongly advocated not mixing the two under any circumstances.

That perception began to change when Simo (see next) posted on the Ldn Yahoo Group his experiences with Ntx and opioids. He demonstrated definitively one could use both, and not only that the Ntx both enhanced the opioid (in his experience) and more importantly the Ntx enabled him to avoid the inevitable dependency that invariably develops with lengthy (weeks-months) use of powerful opioid pain killers.

Simo's experiences and observations

((Simone Aliazoi lives in Switzerland and who due to a serious accident more than 10 years ago has a condition that periodically reoccurs requiring strong opiate/opioid pain killers to treat that inevitably led to addiction and a difficult withdrawal each time. No Longer. Finally now Simo is free from the grip painkillers from for a couple of years and wants to share the experience. )

  • I want to highlight that addiction is not a thing to be ashamed of nor feel guilty about. Addicts have all the same physical problem, doesn't matter what led to it. (Note-Simo is not a doctor.)
  • I've had some experiences with opioids due mainly to my health problems. Tramadol, morphine HCL, buprenorphine mainly but in the past some others. I can say not only you can take them together with LDN, but also LDN will help you with the a lot of issues that opioids bring.

  • Just some words of caution. The only real danger to taking Ldn while using an opioid is to unchain a withdrawal reaction if one has been taking an opioid for some length of time (weeks, months). It is called "precipitated withdrawal" and can be dangerous, for not to speak that it is pure hell, hard and dangerous to reverse. If it happens, you will have to let it pass and is very, very hard. This is the reason because must be avoided at all costs. (Note - That's why it's important to start with a very low dose of Ntx and increase slowly each day to find your right dose.)

  • This only happens when you have already an addiction to a opioids and you take too much naltrexone. Yes, isn't an error, too much. Because you can take naltrexone even if you are addicted to an opioids, but you have to progress carefully to find your own personal individual dose. Unlucky there are only a few experiences or studies on the web, but in that few there is at least one experience in micrograms doses. I dont think is useful at so tiny doses, but you can find this experience on the web.

  • For me opioids are not anymore an option, I have to take them, at least for some weeks, a few times each year. Doctors say forever but I cannot accept it. Now the good news: With Naltrexone you can reverse an addiction (or better yet not get addicted at all), not let it develop your tolerance and avoid some side effects. This is very personal, and dosage varies from person to person, but can be achieved.

  • (Note - this next is for long time opioid users.) My experience was with Morphine and Tramadol. The first time, I was already addicted to morphine and tried 0.05 mg. The next days 0.1 - 0.2 - 0.3 - 0.4 - 0.5 and finally 0.6 mg. With 0.6 mg I had a precipitated withdrawal, it happened half hour after the dose. Hit me very suddenly and very hard.

    At this dosage I was able to reverse withdrawal with another very small dose of morphine but BE AWARE: Naltrexone is a block and you have to break it. The very real risk is to overdose trying to exit from that hell, so again if this happens, only take a small amount of the opioid. Better yet, try to ride it out if you can. The bad feelings should pass in a few hours at most.

    This is why I said you have to avoid this situation at all costs and start low and work your way up. When/if withdrawal precipitated, you're very upset, you feel very bad, you sweat and you hardly can think clear.You would give your right hand for stop that sickness.

    Is important to have someone near that know opioids and Naltrexone, stay calm and focused (as much as possible) and add the right amount of the opioid you are taking, a dose that you are sure is safe. Don't lose the hope, soon you will get better, just need some minutes. Don't try to make this time more short taking higher amount of your opioid, will not work and this is how people dies.

    A better way is to increase the Naltrexone dose more slowly. I've done a big mistake in my experience by taking too much Ntx but I was lucky. Don't play with your health and your life. Start low and work up slowly until you find your own level.

  • Coming back to my experience, next day was at 0.5 mg. These numbers depend from a lot of factors and vary from individual to individual, you have to find your numbers. After a couple of weeks I was at 0.55 without discomfort. You have to safely (slowly) increase your Naltrexone dose. Doesn't matter how much time is needed, trust me you will be grateful that Naltrexone exists.

    When I reached the 4 week mark was around 1mg of Naltrexone, with my usual dose of morphine. One morning I just quit morphine and Naltrexone together and was Ok.No withdrawals at all, no depression, sleep like usual. After a couple of week I resume Naltrexone only with the standard protocol.

    I've done that many times now. When I have to take an opioid, I just lower my dose of Naltrexone because if you don't do it is almost useless to take opioid.

    This is just my experience and should be treated for what is : a single experience. People have a different weight, biochemistry, dna, gender, conditions and so on. We are each unique. What will works for someone won't works with another.

    I'm quite confident that the use of Naltrexone in ver low doses to lessen the side effects, tolerance, addictions for opioid/opiate users will bring good results but needs more work from medical community, not just personal experiences like mine. There are doctors that use it after detox from alcohol or drugs with wonderful results in a hospital setting. But I believe Naltrexone can do much more than this and at lower dosage with minimum side effects.

    Be careful and stay safe.



(While Simo speaks of addiction, he feels strongly that if one took Ntx when first taking an opioid/opiate (or soon after), the risk of possible addiction would likely disappear.)



(More thoughts on addiction by Simo)

. About the final dosage : I notice some effects like little nausea, you cannot feel anymore opiates but you're not in withdrawal or pain for some hours and others little things. I let it work for enough time and I stop.

Enough time mean that I just have a window of time in which I can feel the full effects of opiates. The rest of the time youre not in WD and not high.This window is more short with time, when become very short (few hours) is time to quit.

If I don't get to the point that I cannot explain or show, only feel, the point when you quit without withdrawals, experiences says either was too little time or too low dose.

Oh, I've noticed that in all those years, all experiences are all a bit differents. There is no room for plans with dosages and times that work every time.

I fear to write the same things so, FOR ME, follow some points carefully to make it work:

  • 1. Overcome the fear of naltrexone, especially me, after the experience above. This come naturally if you follow point 2.

  • 2. Avoid precipitated withdrawals with a good balance between naltrexone and opiates.

  • 3. Take a reasonable amount of time and slowly reach the most hightest dose of Ntx you can tolerate. More you stay, better is. Don't try to rush things.

  • 4. You need to want to quit for a real, good reason. If in the morning you feel good but you don't like to "be normal", it will not work. Naltrexone can help physically but cannot change your life.

  • Tramadol is far more complex than a simple opioid. To me is the worst painkiller that I've took, the more hard to wean off. When you quit, you suffer horribles withdrawals. Seem that other people have had similar experiences. Naltrexone can help you to quit but it is more effective with a pure opioid than with tramadol. Maybe its pharmacology could explain why you can take it with naltrexone and why is so hard to leave.

    Tramadol binds opiate receptors but not only, also serotonin and ***norephineprine*** receptors. It acts as SSRI so is either a opioid and a antidepressant. There is a link between serotonin and pain but I don't know much about it. If this is true, is like taking 2 different drugs with 2 different effects.

    I've taken many painkillers (morphine, oxycodone,etc) with naltrexone. Is a very good mix because you can avoid a lot of problems and, when you are ready, you can also quit without suffering for months.

    I dont know why there is a so big fear of mix painkillers with naltrexone.If youre already addicted, the risk is real (sudden very intense withdrawal crisis), but when you already take naltrexone, where is the risk? The worst scenario possible is that the painkiller will not works.If you lower you Ntx dose, the painkiller work for sure.

Simo talks a great deal more about his experiences at Forum Diaspora


OXYTREX - This is a painkiller with oxycodone and naltrexone together. It show reduced side effects, tolerance and dependence.Intersting, show also a increase of the effect of the oxycodone. Double bind study of 719 patients with chronic back pain. Click Here.

FAQ about Oxytrex from the producer (Pain Therapeutics). Click Here.

CASE STUDY - 800mg/day of codeine long term habit with naltrexone in micrograms doses. There are experiences of addicts that take naltrexone in micrograms dose (0.001 mg). Some long-term addicts seem to have a dramatic sensibility to naltrexone. Some says to be able to feel as low as 1mcgr of naltrexone.Note : feeling the effect of naltrexone does not mean to be in withdrawal. In this and others experience, the effect of naltrexone is a improvement of side effects/general well-being/recovery of physical/cognitive functions. Click Here.

NALTREXONE TRIAL DIARY - This is a precious experience and shows how naltrexone can manage the side effects of opioids even in people that dont want to use it to quit. Another important point is the sensibility of addicts to naltrexone and how addicts become less sensibles with time, so more able to tolerate hightest dosage of naltrexone. Notice how the person goes from 0.02 mg of naltrexone to 0.8mg in few weeks.

Extract : "If there's one defintely positive effect from naltrexone usage in such a manner, it's the reduction in the severity of common side effects that opioid users experience. From about the fifth day after initiaton and onwards I've had very little trouble with urinary retention, a problem that has caused me lots of frustration. Another real bonus is the reversal of the opioid's effects on sexual function. My libido has really increased, and is back to the pre-opioid level. Nausea, however, seems to be more apparent, although this probably has more to do with the increased effectiveness of the opioid " Click Here.

CASE REPORT - Ultra-Low Dose Oral Naltrexone Decreases Side Effects and Potentiates the Effect of Methadone. Click Here.

CASE REPORT : THE RON'S STORY. - A doctor used naltrexone with a patient with chronic pain. From LDN RESEARCH TRUST NEWSLETTER,september 2015, page 5. Click Here.


This is only a little part of the materials that support the use of naltrexone with opioid-based drugs.

All the material above is owned by authors. (disclaimer for copyright).


These opinions are published in the public interest, none have been verified by Ian Hewitt or