ReVia
Meaning of ReVia: A tablet that leaves opioid receptors occupied but unstimulated, taking the reward out of both opioids and alcohol.
Definition of ReVia
ReVia is a brand name for naltrexone, a medicine that blocks opioid receptors without stimulating them. It is used to support recovery from alcohol dependence and from opioid dependence. By occupying the receptors it prevents opioids from producing their effect, and in alcohol use it appears to reduce craving and the pleasurable reward that maintains heavy drinking.
How does blocking a receptor help?
Opioid receptors sit throughout the brain and are part of its reward machinery. Heroin and prescription opioids act on them directly. Alcohol acts indirectly, prompting release of the body's own opioid-like chemicals, which is part of why drinking feels rewarding. Naltrexone is an antagonist: it binds the receptor tightly and does nothing there, while preventing anything else from binding. An opioid taken afterward produces little or no effect, and alcohol produces less of the reward that drives the next drink.
What is it used for?
| Use | How it helps |
|---|---|
| Alcohol dependence | Reduces craving and heavy drinking days |
| Opioid dependence | Blocks the effect of opioids after withdrawal is complete |
| Long acting injection | A monthly form removes the need for daily dosing |
What has to happen before it is started?
A person still physically dependent on opioids who takes it will be thrown into immediate and severe withdrawal, because the drug strips the receptors bare within minutes rather than allowing a gradual decline. A period free of opioids is therefore required first, and testing is used to confirm it. The reverse situation matters too: while the block is in place, opioid pain relief will not work normally, which has consequences for injury and surgery. After the drug is stopped, receptors are more sensitive than before, so a dose of opioid that was once tolerated can be fatal.
What are its limits and side effects?
Nausea, headache, dizziness, tiredness and trouble sleeping are the common complaints, most easing over time. Liver enzyme rises have been reported and liver function is generally checked. It is one component of treatment for addiction rather than a treatment on its own, and outcomes are better where it accompanies psychological and social support. Claims that very low doses treat unrelated conditions such as pain syndromes and autoimmune disease remain unproven and are not part of its licensed use.
Also known as
Used in a sentence
ReVia was started once a period free of opioids had been confirmed.
Good to know
Starting naltrexone while opioids remain in the body precipitates abrupt severe withdrawal, and tolerance falls during treatment, so a previously usual opioid dose can be fatal after it is stopped.