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Patient Selection Ideal patient No recent opioid use Interested in cutting back on alcohol use Wants medications to reduce cravings Positive screening on tools such as SASQ, AUDIT-C, AUDIT, or STAD Naloxone challenge [14] Prior to naltrexone initiation, a dose of 0.4 mg IV naloxone can be administered to ensure that naltrexone will not precipitate withdrawal when being taken, Efficacy A 2023 meta-analysis found oral naltrexone (50 mg/d) reduced the risk of returning to heavy drinking (defined often as 5 drinks for men/4 drinks for women), with a number needed to treat (NNT) of roughly 11 [15]

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Melanotan-II administration occurred after the initial 20-day feeding period