Naltrexone Safely Triples Abstinence in Compensated Alcohol-Associated Cirrhosis

This trial provides the first prospective randomized evidence that naltrexone 50 mg/day is both hepatically safe and effective for alcohol use disorder in compensated alcohol-associated cirrhosis, a population routinely denied pharmacotherapy.

📅 Journal publication: Sep 2026 · Last updated: Oct 7, 2026

★ Editor's Picknaltrexoneopioid receptor antagonistalcohol use disorderalcohol-associated cirrhosisabstinencecravinghepatologyrandomized controlled trialhepatotoxicityOCDS Gastroenterology / Hepatology

Also in Behavioral Health / Addiction Medicine

Background Information

Naltrexone triples abstinence rates in alcohol-associated cirrhosis.

Alcohol use disorder (AUD) in patients with alcohol-associated cirrhosis (AaC) poses significant health risks with no current approved treatments. This study evaluates naltrexone for treating AUD in this population. Naltrexone significantly increased abstinence rates: 64% vs. 22% for placebo, and reduced cravings as shown by lower Obsessive Compulsive Drinking Scale (OCDS) scores. Naltrexone is a viable and safe option for managing AUD in compensated AaC without causing liver decompensation, broadening treatment options for this high-risk group. Naltrexone effectively enhances abstinence and reduces cravings in alcohol-associated cirrhosis.

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Authors: Alla M, Varshney M, Bhardwaj A, Kumar G, Shasthry SM, Sarin SK

Citation: Alla M, Varshney M, Bhardwaj A, et al. Naltrexone Is Superior to Placebo for Abstinence and Craving Reduction in Alcohol-Associated Cirrhosis: NAL-CI Trial. Liver international : official journal of the International Association for the Study of the Liver. 2026;46(9):e70845. doi:10.1111/liv.70845

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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