Naltrexone is a prescription-only medication everywhere it’s available. There’s no over-the-counter version. Getting it requires a doctor’s appointment, a brief discussion of your drinking, and in most cases a prescription that costs almost nothing because the medication has been generic for over twenty years. The friction is rarely the medication itself. It’s finding a prescriber willing to discuss it. This article is part of our Naltrexone hub, the complete guide to using naltrexone for alcohol use disorder.

This article walks through the realistic routes in the three biggest English-speaking markets: the US, UK, and Australia. The mechanics differ; the underlying message is the same. Naltrexone is well-established, off-patent, low-cost, and broadly available to anyone who asks for it competently. If your first doctor declines, the second probably won’t.

# Why this is harder than it should be

A 2014 JAMA study found that fewer than 9% of US patients with alcohol use disorder were ever offered any FDA-approved medication for it. Twelve years later the gap has narrowed but remains wide. Most general practitioners receive minimal addiction-medicine training. Many haven’t prescribed naltrexone in years and feel out of practice. Some still believe (incorrectly) that naltrexone is reserved for severe alcohol dependence diagnosed by a specialist.

You may need to advocate for the medication you want. Walking in informed makes a substantial difference. Bring this:

  • A clear sentence about your drinking pattern (e.g. “I drink 3-4 nights a week, 4-6 drinks per session, and I’d like to reduce”)
  • The protocol you’re asking about (Sinclair Method targeted dosing, or daily naltrexone)
  • An understanding that you do not need to be alcohol-dependent or symptomatic to qualify for treatment

Alcohol use disorder is a spectrum. Mild AUD (2-3 DSM-5 criteria) is the most common presentation and naltrexone is appropriate for it. Pretending you have severe symptoms to “qualify” is unnecessary. Many prescribers will treat anyone who reports problematic drinking and wants to address it.

# United States

In the US, naltrexone is licensed for alcohol use disorder and has been since 1994. Several routes exist.

# Through a primary care physician (PCP)

Your GP can prescribe naltrexone. Many haven’t, but most can. Bring:

  • Your AUDIT-C or AUDIT score if you have one (we cover the AUDIT-C self-test in the AlcoScore hub)
  • A specific request: “I’d like to try 50mg naltrexone, either daily or via the Sinclair Method”
  • Liver function test results if you have them recent (LFTs are sometimes requested before starting)

If your PCP is unwilling, ask for a referral to addiction medicine or behavioral health. Many large primary care practices have an embedded addiction specialist.

# Through telemedicine

Several US telehealth services specialise in alcohol use disorder treatment and prescribe naltrexone routinely:

  • Ria Health (ria.health): pioneer of remote AUD treatment, includes coaching and the Sinclair Method as a standard option
  • Oar Health (oarhealth.com): naltrexone-focused, monthly subscription model
  • Workit Health (workithealth.com): broader addiction medicine including naltrexone

Telemedicine is often faster than your PCP. A typical first appointment within 1-2 weeks, prescription within days, medication in your hand within a week of starting.

# Cost

Generic naltrexone (oral, 50mg tablets) is cheap. Without insurance, expect:

  • $20-50/month at most US pharmacies
  • $4-10/month at GoodRx-style discount pharmacies
  • $0-15/month with most insurance plans

Vivitrol, the monthly intramuscular injection version, is much more expensive (around $1,500 per shot before insurance) but is fully covered by Medicaid and Medicare in most states. Vivitrol is most useful for patients with adherence challenges. The pillar covers Vivitrol vs oral naltrexone in more detail.

A laptop on a desk in a home office, suggesting a telemedicine appointment.
Photo by Tim Samuel on Pexels

# United Kingdom

In the UK, naltrexone is licensed and used widely in NHS addiction services, but it’s underprescribed in primary care because GPs typically refer alcohol cases to specialist alcohol services.

# Through the NHS

The standard route is:

  1. Talk to your GP about your drinking. Frame it as “I’d like to reduce my drinking and I’ve read about naltrexone.”
  2. Get a referral to local alcohol services. In England these are commissioned at local-authority level (Change Grow Live, Turning Point, We Are With You, and similar). In Scotland, Wales, and Northern Ireland the structure varies.
  3. The alcohol service prescribes naltrexone, typically alongside structured support. Some services prescribe quickly; others run group programs first.

Wait times vary widely. Some areas: 2-4 weeks. Some: 3-6 months.

If your GP is willing to prescribe directly without referral, that’s faster. Some GPs will, especially if you’re confident, articulate, and have done your reading. Bring the same materials suggested above for the US.

# Through private healthcare

If NHS wait times are long or your GP declines, private prescriptions are available:

  • Private GP appointments typically £80-150, with the prescription itself costing roughly £10-20/month at most pharmacies
  • Online private GP services like Livi, Babylon, Push Doctor, and Doctor Care Anywhere offer remote consultations. Some will prescribe naltrexone; some won’t. Worth calling ahead.
  • Specialist private addiction services like the Priory or smaller independent clinics have addiction-medicine prescribers. More expensive but more confident with naltrexone specifically.

# Cost

NHS prescriptions are free in Scotland, Wales, and Northern Ireland. In England, the standard prescription charge is £9.90 (2026) per item, or you can pay an annual prepayment certificate of £114.50.

Private prescriptions: £10-25/month for the medication itself, plus the consultation cost.

# Australia

In Australia, naltrexone for alcohol dependence is PBS-listed (Pharmaceutical Benefits Scheme), meaning it’s heavily subsidised when prescribed for the right indication.

# Through a GP

Australian GPs can prescribe naltrexone. The PBS authority requirement was simplified some years ago, so most GPs can write it without specialist sign-off in most circumstances. The key is that they recognise alcohol use disorder as the indication and feel comfortable initiating.

If your GP is willing:

  1. Standard consultation, discuss your drinking honestly
  2. They prescribe 50mg daily or as-needed depending on protocol
  3. PBS pricing applies if you meet the criteria

# PBS criteria

Naltrexone is PBS-listed for “alcohol dependence” with these conditions:

  • The patient is participating in a comprehensive treatment program with goals consistent with abstinence (sometimes interpreted strictly, sometimes loosely)
  • The patient has been counselled about the risks of opioid use during treatment
  • An LFT (liver function test) has been performed before starting

Some GPs interpret “comprehensive treatment program” strictly and want you to be in counselling or AA before prescribing. Others are happy if you’re using the medication alongside any structured plan, which can include self-directed reduction with an app like AlcoLog.

If your GP is being strict about this, ask whether you’d qualify with a different framing or whether they can refer you to an Addiction Medicine Specialist who is more familiar with the medication.

# Through a private prescription

Outside PBS, naltrexone is available privately at full cost (around AUD $40-80/month). Some patients pay this temporarily while sorting out PBS authority or if they want to start immediately while their GP referral processes.

# Through alcohol services

Australia has good public alcohol and drug treatment services through state health departments. Self-referral is possible. They prescribe naltrexone routinely.

# What to do if your doctor refuses

This happens. Common reasons (mostly outdated or misinformed):

“You don’t seem dependent enough to need medication.” Naltrexone is appropriate for the full spectrum of alcohol use disorder, including mild. Push back: cite the 2008 COMBINE study or NICE guidance (UK) which recommend medication-assisted treatment for AUD across the severity spectrum.

“I’m not familiar with this medication.” Fair: ask for a referral to someone who is. Don’t accept “no specialist available” as a closure; the wait may be long but the pathway exists.

“Have you tried just cutting back / AA / counselling first?” Both can be done alongside naltrexone, not instead of. Cite the Sinclair Method explicitly if you want targeted dosing: the protocol is specifically designed for people continuing to drink while gradually extinguishing the urge.

“It’s only for severe alcoholics.” Outdated. Modern guidance (NICE 2011 onwards, US CDC, Australian Royal College guidance) all support medication for moderate AUD.

“It has dangerous side effects.” Mostly mild and transient. Our Naltrexone side effects article walks through what’s actually likely.

If a doctor still refuses after a calm, informed conversation, your options:

  1. Ask for the refusal to be documented in your notes and request a second opinion or referral
  2. Switch to a different practice or doctor
  3. Use telemedicine (US) or private route (UK, AU)
  4. Self-refer to alcohol services where this is possible (NHS in some areas, public health services in Australia)

You shouldn’t have to fight for a 30-year-old generic medication, but if you do, persistence usually pays off. Most patients who push through one or two refusals end up with a prescription within a month.

# What about ordering online without a prescription

Briefly, since people ask: there are international pharmacies that ship naltrexone without a verified prescription. We don’t recommend this route for several reasons:

  • Quality control is variable. You’re trusting that a tablet labelled “naltrexone 50mg” actually contains naltrexone at the right dose.
  • It’s illegal in most jurisdictions to import prescription medications without a prescription.
  • You miss the medical oversight that catches drug interactions, particularly with opioids (a serious risk).
  • The savings are minimal compared to legal generic options ($4-10/month in the US, free or near-free in NHS, PBS-subsidised in Australia).

If access is genuinely impossible through legitimate routes, talk to a harm reduction service before ordering from an unverified source.

A modern pharmacy interior with shelves and a clean counter.
Photo by cottonbro studio on Pexels

# How AlcoLog helps when you start

Once you have a prescription, AlcoLog tracks the dose alongside your drinks. The Medications card has a dedicated naltrexone entry. Each dose gets a timestamp via the 24-hour time picker, which is what your prescriber will want to see at your follow-up appointment if you’re using the Sinclair Method and they want to verify your timing compliance.

The redose timer reminds you about the second tablet on long sessions. Pro-tier location reminders fire when you arrive at saved locations (the pub, a friend’s house) so you don’t realise at first drink that you forgot.

AlcoScore deliberately excludes medication use from its scoring, so your protocol adherence informs you privately rather than feeding into a public-facing score. Data stays on the device. CSV export of your last 10 sessions is free; unlimited export and PDF reports are on Pro for sharing with your prescriber at the 1-month and 3-month follow-ups.

Try AlcoLog free →

Back to the Naltrexone hub →