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Substance Abuse & Naltrexone Hydrochloride

March 22, 2022
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WRITTEN BY Dr. Ramon Martinez III

Executive Summary 

Prolonged use of prescription opioids for pain can often cause enhanced pain sensitivity and dependence, potentially leading to a substance use disorder. Opioid-related overdoses and deaths have been on the rise in recent years in the U.S. and early medication-assisted treatment strategies for dependent users may help mitigate these fatal effects and reduce overall dependence. Two bills (HB 2603 and SB 1037) have been introduced to allow the distribution of the addiction-mitigation drug naltrexone hydrochloride (Revia) by physicians and pharmacists upon approval of the Department of Health and Senior Services, and to allow anyone to possess naltrexone.


  • In 2018, 1 in 56 deaths in Missouri were attributable to opioid overdoses; various drugs can help rescue an overdose victim or help mitigate addiction long term.
  • Naltrexone hydrochloride is an approved drug for the mitigation of alcohol and opioid use disorder which can reduce drug cravings and prevent relapse. Naloxone hydrochloride is a drug meant to rescue a patient experiencing an opioid overdose, and can be as high as 75–100% effective at reversing mortality.
  • All states have some form of coverage under the Medicaid program for naltrexone as an approved oral medication-assisted treatment strategy for opioid dependence.


  • Extensive data on the efficacy of naltrexone is limited given the low adoption of the drug in addiction mitigation programs. 
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