Background Naltrexone is an opioid receptor antagonist used in the treatment of alcohol and opioid dependency. Its efficacy has been demonstrated in a variety of studies. In the United States it is available as an oral or injectable medication but in the UK it is only available via the oral route.

Aims This manuscript evaluates the evidence supporting the use of naltrexone in addiction treatment. The aim is to assess the overall safety, efficacy and cost-effectiveness of naltrexone.

Results Overall, each modality of naltrexone showed superior treatment outcomes when compared to non-medication therapies. When used appropriately, naltrexone blocks the reinforcing effects of opioids, is not associated with tolerance, withdrawal, or abuse potential, and decreases the likelihood of relapse to opioid use.

Conclusions Naltrexone is a cost-effective treatment that promotes and supports the abstinence of opioid use across a wide range of demographics and severity characteristics. Further research is needed to generate more definitive, evidence-based conclusions.