Naltrexone

Let’s talk about naltrexone. It’s one of those tools in the pharmacopeia that, over my twenty-odd years in clinical practice, has evolved from a very niche, specific agent into something with surprisingly broad—and sometimes controversial—applications. If you’d asked me about it in the late 90s, I’d have said it’s for opioid and alcohol dependence, full stop. End of story. But medicine, as we know, is rarely that simple. The journey of naltrexone from a straightforward blocker to a nuanced modulator is a fascinating case study in drug repurposing and the sometimes serendipitous nature of clinical observation.