To be eligible for naltrexone after opioid use, how long must a person be abstinent from all opioids, including buprenorphine?

To be eligible for naltrexone after opioid use, how long must a person be abstinent from all opioids, including buprenorphine?

• A. 24-48 hours
• B. 6 weeks
• C. 7-14 days
• D. 1 month

Answer: (C)

You must be opioid-free long enough to avoid precipitated withdrawal when starting naltrexone. Naltrexone is a pure opioid antagonist, so if any opioids remain in the system, it can displace them from receptors and trigger sudden, severe withdrawal. Buprenorphine, in particular, has very high receptor affinity and a long duration of action, which means it can linger on receptors and keep opioids effectively occupying them for days and even weeks. Because of this, the recommended window to safely initiate naltrexone is about 7 to 14 days of abstinence from all opioids, including buprenorphine. Shorter intervals (like 24–48 hours) are at high risk of precipitated withdrawal, while much longer waits (6 weeks or a month) are unnecessary in most cases.

You must be opioid-free long enough to avoid precipitated withdrawal when starting naltrexone. Naltrexone is a pure opioid antagonist, so if any opioids remain in the system, it can displace them from receptors and trigger sudden, severe withdrawal. Buprenorphine, in particular, has very high receptor affinity and a long duration of action, which means it can linger on receptors and keep opioids effectively occupying them for days and even weeks. Because of this, the recommended window to safely initiate naltrexone is about 7 to 14 days of abstinence from all opioids, including buprenorphine. Shorter intervals (like 24–48 hours) are at high risk of precipitated withdrawal, while much longer waits (6 weeks or a month) are unnecessary in most cases.