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Low Dose Naltrexone: New Uses For An Old Drug

If you haven't heard of low dose naltrexone, you probably aren't alone. Naltrexone has been used conventionally to treat alcohol and opioid dependence since the 1970's. At much lower doses (ie. 1/10th the conventional dose), researchers are finding that drug has the potential to treat a number of ailments ranging from auto-immune conditions to chronic pain. However, since the exclusive manufacturing rights to naltrexone expired long ago, there isn't much financial incentive for companies to fund research and marketing for low-dose naltrexone (LDN). So it's up to independent researchers and us as clinicians to move the science forward and educate patients about this new therapy.

As Dr. Jill Carnahan's article describes in detail, LDN is quickly gaining traction as a novel treatment for conditions like Crohn's disease, fibromyalgia, multiple sclerosis, and more. LDN seems to work by binding to the body's opioid receptors, which play a significant role in modulating the immune system. One small study showed that LDN even has the potential to induce remission in Crohn's disease, an incurable auto-immune condition of the gastrointestinal tract. In fibromyalgia, preliminary research shows that LDN improves symptoms and decreases markers of inflammation. Research continues to broaden the clinical implications of LDN.

What makes LDN so unique to me is its safety profile. Conventional treatments for the aforementioned conditions are usually riddled with serious side effects. Drugs that treat auto-immune conditions do so by dampening the body's immune system. Although this can reduce severity of symptoms, it can also expose the body to serious infections and abnormalities of the blood cells. Chronic pain treatments are similarly imperfect. Long term, high dose, and sometimes inappropriate prescribing of opioid pain killers in chronic pain has no doubt contributed to the opioid epidemic in North America. Although the use of LDN for these indications is still in its experimental phase, there is much comfort in knowing that it can be used safely. The most commonly reported side effect is an increase in vivid dreams, and headache in a handful of studies. Drug interactions are non-existent, unless the patient is on very high doses of opioid medications. As a compounding pharmacist, I have seen first hand how valuable LDN can be in treating conditions that have otherwise been difficult and frustrating for my patients.

It is my hope that research continues to expand our understanding of LDN’s clinical  applications so that in the near future, more patients may benefit from this safe and effective therapy.

Ying Wang, BSc. (Pharm), RPh.
Pure Integrative Pharmacy, West 4th location