Low Dose Naltrexone for Pain Management

According to the Centers for Disease Control and Prevention (CDC), approximately 24.3% of U.S. adults experienced chronic pain in 2023. 8.5% of adults had high-impact chronic pain that obstructed them from their major daily activities. This prevalent health condition is treated with different medications. A low dose of Naltrexone has given promising results in both chronic and high-impact chronic pain, even though it is not FDA-approved for pain management.

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What Is Low-Dose Naltrexone (LDN)?

Naltrexone is a medication that is used for the treatment of opioid use disorder (OUD) and alcohol use disorder (AUD). Low-dose naltrexone (LDN) typically refers to about 10%  or less of the dose used to treat opioid addiction. The standard dose of naltrexone for opioid addiction treatment is 50mg to 100mg. According to a research paper by Karlo Toljan and Bruce Vrooman3, a low dose of naltrexone is typically between 1 to 5 mg per day. However, most patients are commonly prescribed 4.5 mg per day.

How Low-Dose Naltrexone (LDN) Helps Manage Pain

When LDN temporarily blocks the opioid receptors in the brain and immune cells, it increases the production of endorphins. Endorphins are natural chemicals produced by the body that help reduce pain and improve mood. Lower-dose naltrexone also increases the number of opioid receptors, which help the body regulate pain more efficiently.

Low Dose Naltrexone Uses

Although limited research is available about the benefits of LDN, it has given promising results for different kinds of health conditions. Below are some of the most notable examples of such diseases:

• • Chronic Pain: Pain for 3 months or longer.
  • Autoimmune Thyroid Disorders: When the Immune system attacks the thyroid.
  • Cancer: Treatment of bladder, breast, liver, lungs, colon, and rectum cancers.
  • Chronic Fatigue Syndrome: Continuous tiredness that doesn’t go away with rest.
  • Gulf War Syndrome: Gulf War veterans experience fatigue, pain, and memory problems.
  • Myalgic Encephalomyelitis: Severe fatigue syndrome with other symptoms like brain fog.
  • Crohn’s disease: Inflammation in the digestive tract.
  • Fibromyalgia: A widespread body pain, tiredness, and sensitivity.

• Multiple Sclerosis: The Immune system damages the nerves, causing problems with movement, balance, or vision.

• Long Covid: Symptoms like fatigue, brain fog, and shortness of breath continue for weeks or months, even after the COVID-19 infection is cleared.

The Paradoxical Effect of Low and High Doses of Naltrexone

Low-dose naltrexone works oppositely to high-dose; this is often referred to as the paradoxical effect. The effects of LDN are explained below:

1. The low dose of naltrexone briefly blocks feel-good chemicals, called natural opioids. The brain responds by making more of these chemicals, which helps improve mood and reduce pain.
2. It also calms down the special immune cells in the brain (called microglial cells). When these cells become too active, they cause pain, inflammation, tiredness, and flu-like symptoms. LDN reduces this overactivity by blocking a specific receptor (called TLR-4 4).
3. The low-dose naltrexone also increases the production of endogenous opioids, which provide relief from pain, fatigue, stress, and inflammation.  

Side Effects of Low-Dose Naltrexone

Naltrexone For Chronic Pain vs High-Impact Chronic Pain

The difference between chronic pain and high-impact chronic pain lies in their duration and impact. Sometimes, both overlap with each other. Both types of pain persist for a longer period, but simple chronic pain doesn’t stop a person from doing their daily activities. In contrast, high-impact chronic pain affects these activities, restricting their ability to participate in work, social activities, and self-care.

Things to Avoid While Taking Low-Dose Naltrexone

a. Opioids

Naltrexone blocks the euphoric effects of various opioids. That’s why, while taking naltrexone, you should avoid using all kinds of opioids to prevent opioid symptoms. Common opioid withdrawal symptoms include nausea, vomiting, loss of appetite, anxiety, and sweating.

b. Alcohol

In 2023, the NSDUH reported that 177.3 million people aged 12 and older (about 62.5% of them) said they had a drink sometime in the past year. Keeping in mind the prevalence of alcohol use in the U.S., it is recommended that you completely give up drinking alcohol before taking naltrexone. Doctors also recommend keeping away from alcohol during treatment because, while taking naltrexone, heavy alcohol use can cause liver damage.

Your recovery from alcohol starts with one step— Feel free to talk to our specialists by booking an appointment at 844.445.2565 or on this form.

c. Certain Medications

As a general principle, you should avoid any medications that contain opioids. These medications include cough, cold, or antidiarrheal medications. While taking low-dose naltrexone, you should inform the doctor about any medication that you intend to use.

How Does Low-Dose Naltrexone Offer New Hope in Cancer Support?

The National Cancer Institute projected that in 2025, more than 2 million new cases of cancer will be diagnosed and 618,120 people will die from the disease in the United States. LDN  has shown promising results in various types of cancer treatment. A recent study9 shows that LDN increased the number of certain opioid receptors and helped stop cancer cells from multiplying. Another study reported that LDN might help protect healthy brain cells by preventing unnecessary cell death. LDN also changes macrophages from a type that helps cancer grow (M2) to a type that fights cancer (M1).

Naltrexone Prescription at ChoicePoint

ChoicePoint offers same-day naltrexone prescription statewide in NJ, and you do not even have to visit us on-site. Get an online naltrexone prescription for AUD or OUD within the comfort of your own home. Plus, it’s covered by commercial insurance. So, if you need an emergency prescription or have run out of refills, call us at 844.445.2565 or fill out this form. 

If you need a comprehensive treatment, get enrolled in our medication-assisted treatment, which comprises both therapy and medication for a holistic addiction recovery. We can be your one-stop shop for all SUD-related issues.

Frequently Asked Questions

How long does it take low-dose naltrexone to work?

Generally, low-dose naltrexone should be used for 8 to 10 weeks to see if it works. After this period, you’ll have a better idea of whether it’s effective for you or not.

Is LDN approved by the FDA for pain management?

So far, no dosage of naltrexone has been approved by the FDA for the treatment of chronic pain and inflammatory diseases. The FDA has also not approved it for the treatment of any other medical condition. It has been approved only for opioid use disorder or alcohol use disorder.

Is LDN addictive or habit-forming?

According to an article by Jarred Younger, Luke Parkitny, and David McLain, no one has misused low-dose naltrexone or become addicted to it. People also don’t build a tolerance to it, meaning it doesn’t stop working if used for a longer period.

How long does it take to feel relief?

Some people feel better within a few weeks, but it can take 1–3 months to notice full effects. Results vary depending on the condition being treated.

Are there any dietary or lifestyle changes that support LDN’s effects in pain management?

Yes. An anti-inflammatory diet, regular sleep, and stress management may enhance LDN’s benefits, as it works partly by reducing inflammation and balancing immune activity.

Sources

1. Lucas, J. W., & Sohi, I. (2024). Chronic pain and high-impact chronic pain among U.S. Adults, 2023.
   https://doi.org/10.15620/cdc/169630
2. Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4), 451–459. https://doi.org/10.1007/s10067-014-2517-2
3. Toljan, K., & Vrooman, B. (2018). Low-Dose naltrexone (LDN)—Review of therapeutic utilization. Medical Sciences, 6(4), 82.
   https://doi.org/10.3390/medsci6040082
4. Wang, H., et al. (2017). TLR4 mediates the synergistic effect of low-dose naltrexone and morphine on neuropathic pain suppression. Journal of Biological Chemistry, 292(13), 5760–5770.
   https://doi.org/10.1074/jbc.M116.766329
5. International Association for the Study of Pain. (2023, July 17). High-Impact Chronic Pain – International Association for the Study of Pain (IASP). International Association for the Study of Pain (IASP).
   https://www.iasp-pain.org/resources/fact-sheets/high-impact-chronic-pain/
6. Alcohol use in the United States: Age groups and demographic characteristics | National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.-e).
   https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-use-united-states-age-groups-and-demographic-characteristics
7. Younger, J., Parkitny, L., & McLain, D. (2014b). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4), 451–459.
   https://doi.org/10.1007/s10067-014-2517-2
8. Cancer statistics. (2025, May 7). Cancer.gov.
   https://www.cancer.gov/about-cancer/understanding/statistics
9. Ciwun, M., Tankiewicz-Kwedlo, A., & Pawlak, D. (2024). Low-Dose naltrexone as an adjuvant in combined anticancer therapy. Cancers, 16(6), 1240.
   https://doi.org/10.3390/cancers16061240
10. Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4), 451–459.
    https://doi.org/10.1007/s10067-014-2517-2