In people with alcohol dependence, naltrexone is an effective and safe treatment to help people to refrain from drinking. Data on other opioid antagonists is limited.

Randomized controlled trials including around 4000 participants show that, compared with placebo, naltrexone results in fewer people returning to heavy or any drinking at post treatment and at 3 to 12 months, reduces drinking days, rates of heavy drinking and consumed amount per drinking at post treatment but increases the risk of adverse effects (abdominal pain, daytime sleepiness, dizziness, dyspepsia, insomnia and vomiting).

When naltrexone was compared with acamprosate, no clear benefit of one treatment over the other was seen. Similarly, naltrexone plus acamprosate was no more effective than placebo or naltrexone alone at improving outcomes. Data on nalmefene were too sparse to draw meaningful conclusions.