Online Alcohol Addiction Treatment — Naltrexone by Telehealth

FDA-approved medications to reduce cravings and support recovery from alcohol use disorder, prescribed and managed by a licensed physician via secure video visit. Available in California, Washington, and Nevada. New Mexico — Coming Soon. Care is delivered by secure video visit in most locations. In-person visits may be required in the Tacoma, WA and Reno, NV areas.

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Alcohol use disorder is a medical condition

Alcohol use disorder — also called alcohol dependence or alcoholism — is a chronic brain condition, not a moral failure or a lack of willpower. It involves changes to the brain's reward system, stress response, and executive function that make controlling alcohol use genuinely difficult, regardless of how much someone wants to stop.

According to the National Institute on Alcohol Abuse and Alcoholism, approximately 29.5 million Americans meet the criteria for alcohol use disorder in any given year. Fewer than ten percent receive treatment. The treatment gap for alcohol use disorder is, if anything, larger than for opioid use disorder.

Effective, FDA-approved medications exist for alcohol use disorder. They are underused, underknown, and underutilized — often because providers and patients alike are unaware they exist, or because stigma prevents patients from seeking help in the first place.

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Medications for alcohol use disorder

Naltrexone (oral)

Naltrexone is an opioid antagonist — it blocks opioid receptors in the brain. Because alcohol produces some of its rewarding effects through the opioid system, blocking those receptors reduces the pleasure response to drinking. Over time, the craving diminishes because the brain stops associating alcohol with its usual reward.

Naltrexone is taken as a daily oral tablet. It does not make you sick if you drink — that is a common misconception that confuses naltrexone with disulfiram (Antabuse). It simply reduces the reinforcing effect of alcohol. Many patients find they lose interest in drinking over time.

Naltrexone can also be used with a protocol called the Sinclair Method — taking it specifically before drinking rather than daily, which allows the medication to work during drinking episodes to gradually extinguish the conditioned response.

Vivitrol (injectable naltrexone)

Vivitrol is an extended-release injectable formulation of naltrexone administered once monthly. It produces the same effects as oral naltrexone but eliminates the daily pill — which is a significant advantage for patients who struggle with medication adherence. A monthly appointment is required for the injection.

Acamprosate

Acamprosate works differently from naltrexone — it targets the glutamate system rather than the opioid system, and is thought to reduce the anxiety and restlessness associated with early sobriety. It is most effective for patients who have already stopped drinking and want support maintaining abstinence. Unlike naltrexone, acamprosate does not work if the patient is still drinking.

Which medication is right for you?

Your provider will discuss your situation — your drinking patterns, your goals (abstinence vs. reduction), your other medications, your medical history, and your preferences — and recommend the approach most likely to be effective for you. Many patients do well with naltrexone. Some prefer Vivitrol. Some benefit from combination approaches. There is no single right answer.

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What to expect from treatment

Initial visit: A telehealth video visit with a physician lasting approximately 30 to 45 minutes. You complete an intake form before the visit covering your drinking history, medical history, medications, and treatment goals. Your provider reviews this before the appointment.

Prescription: Naltrexone is sent electronically to your pharmacy. Vivitrol requires a monthly in-person or in-office injection — your provider will coordinate this.

Follow-up: Monthly telehealth visits to monitor your response to medication, adjust the approach if needed, and support your progress.

No detox required for naltrexone: Unlike some other medications for alcohol use disorder, naltrexone does not require you to detox before starting. You can begin while still drinking. Acamprosate, however, works best after you have stopped drinking.

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Availability by state

State	Insurance	Availability
California	Private pay only — $249/month	Telehealth statewide
Washington	Commercial insurance, Apple Health (Medicaid), self-pay	Telehealth statewide + in-person University Place
Nevada	All insurance including Medicaid	Telehealth statewide + in-person Reno
New Mexico	—	Coming Soon

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Frequently asked questions

Do I need to stop drinking before I start treatment? Not necessarily, and not immediately. Naltrexone can be started while you are still drinking — in fact, some approaches specifically use it this way. Acamprosate is more effective once you have stopped. Your provider will advise based on your specific situation and goals.

Is naltrexone the same as Antabuse? No. Antabuse (disulfiram) causes an extremely unpleasant reaction if you drink while taking it — flushing, nausea, vomiting, heart palpitations. It is an aversive therapy. Naltrexone works completely differently — it blocks the rewarding effect of alcohol without causing any reaction if you drink. Many patients find naltrexone much more tolerable and continue it long-term.

Does insurance cover medication for alcohol use disorder? In most cases, yes. Under the Mental Health Parity and Addiction Equity Act, commercial insurance plans are required to cover alcohol use disorder treatment at parity with other medical conditions. Naltrexone is a generic medication and is typically covered with a low or no copay. Vivitrol is brand-name and may require prior authorization. In California, Rezolv Health is private pay — medication costs are separate from the membership fee and filled at your pharmacy.

Can I drink at all while on naltrexone? You can, but the goal is to change your relationship with alcohol. Many patients using the Sinclair Method — taking naltrexone before drinking — find that their drinking naturally decreases over time without requiring strict abstinence. Others use naltrexone with a goal of complete abstinence. Your provider will help you set appropriate goals based on your situation.

How quickly does naltrexone work? The blocking effect of oral naltrexone begins within one to two hours of taking a dose. Some patients notice a reduction in cravings within the first week. The full effect on drinking patterns may take several weeks as the brain's conditioning changes. Vivitrol reaches its full effect within days of the injection and is maintained for the full month.

Is alcohol use disorder treatment confidential? Yes. All treatment is protected under HIPAA. In California, where we do not accept insurance, no claims are filed — your treatment is completely private. In other states where insurance is billed, a diagnostic code is submitted but this information is protected by federal privacy law and cannot be shared without your consent except in very limited circumstances.

What if I have already tried naltrexone and it did not work? Naltrexone is not effective for everyone, and non-response is a clinical reality. If you have tried it without success, your provider will review what happened — whether it was adherence, dose, timing, or a genuine non-response — and consider other approaches including acamprosate, combination therapy, or other clinical strategies.