Low Dose Naltrexone for Chronic Pain

Published on by Mary Jones
Photo by Charles Parker on Pexels.com

If there is anything that can get in the way of your living your best life, it’s chronic pain.

I have been suffering from arthritis since I was 20. I tried many different types of prescription medication, with disappointing results and intolerable side effects.

In desperation, I did a Google search and learned about low-dose naltrexone (LDN). I have been taking this for two years with very good results. In case you are suffering with similar pain and inflammation, talk to your doctor about low dose naltrexone.

One doctor opined that the pain-relieving properties of LDN were nearly or as good as opioids but without the addictive side effects.

Here is a video from a rheumatologist who explains how LDN works:

Conditions Treatable with Low Dose Naltrexone

Naltrexone is a drug that is typically used to treat people with addictions to alcohol, drugs, gambling and food. It works by controlling impulses to certain behaviors. However, some doctors and researchers have found that, in very low doses, it has been helpful for treating some patients with pain and inflammation associated with

  • Crohn’s disease
  • Multiple sclerosis
  • Rheumatoid arthitis
  • Fibromyalgia
  • Parkinson’s Disease
  • Sciatica
  • Herniated disc
  • Lower limb neuropathy
  • Dental pain
  • Some skin disorders
  • Some cancers (appearing to shrink tumors)
  • Depression
  • Autism

I would say that all sounds too good to be true if I had not had positive results myself. There are abundant studies and clinical trials to support at least exploratory trials of this inexpensive medication.

So, if it’s so great, why aren’t doctors prescribing it more often?

Low dose naltrexone has not been approved by the FDA for off-label use for pain and inflammation. However, there are many, many citations in reputable medical journals about its usage. It has been combined with Bupropion into the very expensive prescription, Contrave, for curbing the cravings associated with weight gain. Doctors have been prescribing it off-label for more than a decade. I have convinced my doctors to prescribe it when I have shown them the studies (see Sources). Naltrexone is a medication that is very inexpensive, available generically and that has relatively few side effects. A bottle costs about $30. However, at the low dosage administration, you can get 10 times or more as much medication out of the bottle. That treatment is 10 cents or less a day. Think about what typical pain management costs. It may be that major clinical trials do not support the examination of existing, safe and inexpensive medications.

Low Dosage is Key

Naltrexone comes in 50 mg tablets but to benefit from its anti-inflammatory properties, you must take a low dose: between 1 mg. and 5 mg. The drug is not effective for this purpose at higher doses.

It may initially seem strange that a medication can have an opposite effect when given at a low dosage. However, there is a strong precedent for this concept—and with opioid-related drugs in particular. A paradoxical hyperalgesic effect of low-dose morphine was first widely reported in 1987 []. Morphine was administered via the IV route to rats after arthritis was induced using Freund’s adjuvant. A dose of 100 μg/kg produced clear analgesia, 50 μg/kg produced less significant analgesia, and 30 μg/kg showed no difference from saline. At around 10 μg/kg, however, the researchers saw the development of morphine hyperalgesia, which became most pronounced at 6 μg/kg. This finding, which has been replicated several times (e.g., []), suggests that there is a small window at which opioid analgesics produce the opposite effects than those typically expected. The dosage of morphine that appears to cause paradoxical hyperalgesia is approximately 1/10th of the dosage typically used to produce analgesia. We note that the dosage of naltrexone that is used to reduce pain is also approximately 1/10th of the dosage used for substance abuse treatment.

— The Use of Low Dosage Naltrexone, Journal of Clinical Rheumatology

How to Compound Low Dosage Naltrexone at Home

It is very difficult to chop up the tablets that small. I have tried. An easier way is to compound the medication. A compounding pharmacy can do this for you but you can also do it yourself. Crush 10 tablets into a fine powder. You can do this on a plate, using a glass and a spoon to crush and pulverize the tablets. You will end up with 500 mg of powdered Naltexone. Mix this powder into 500 ml (about 16.9 oz) of distilled water in a sealable container. Store it in the refrigerator. To take the medicine, you will need an eye-dropper. Ask your doctor what dosage is right 1 ml, 2 ml, 3 ml, 4 ml or 5 ml. It tastes bitter so dropping the tiny amount of compounded medicine into some orange juice (juice with pulp helps with the grit) may make it more palatable to take.

Reputable Sources:

Here is some information you may wish to share with your doctor.

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