Can opioids be taken with Low Dose Naltrexone (LDN)?

Can opioids be taken with Low Dose Naltrexone (LDN)?

Are there any pharmaceuticals that LDN is contraindicated in?

I hear to stop using LDN in patients who are on opioids, but when I talk to the pharmacist about this, they say it is safe to use together. 

Okay, so this is a complicated nuanced question here. So, the official answer is, Naltrexone blocks opioids. And so any medication that has an opioid action, like Oxycodone, Hydrocodone and Tramadol, Fentanyl, Morphine, those are, of those theoretically or technically speaking, they're supposed to be contraindicated. 

Now with that said, low doses of Naltrexone, like really low doses, sometimes even microdosing, it doesn't block the opioid receptors fully. So there are plenty of doctors out there who actually encourage the use of Naltrexone and LDN alongside opioids. 

But that's kind of up to the doctor to kind of determine it. So medical advice, or the medical thinking, is that it's contraindicated, but if you know, if you have somebody who knows what they're doing, the danger there with mixing opioids in naltrexone is withdrawal. Withdrawals can be very, very serious and very uncomfortable. Unless a patient is working with a doctor or a health care provider that knows exactly what they are doing mixing the Naltrexone with the opioids, you're playing with fire. 

So the official answer is don't mix them, but if they already are going to mix, then make sure you do it with somebody that knows what they’re doing.