Multiple medications are approved for the treatment of AUD, yet less than 5% of individuals with an AUD currently receive treatment. We are developing OPNT002, a rapid onset formulation of nasal naltrexone for the treatment of AUD. Alcohol is a potent trigger for the release of the brain’s naturally occurring opioids (endorphins). This release stimulates several distinct types of opioid receptors which produce an elevation of the brain’s “pleasure transmitter”, dopamine.
By blocking opioid receptors, opioid antagonists like naltrexone reduce the effects of endorphins released by alcohol. This blockade blunts the pleasurable (reinforcing) effects of alcohol. This can result in lower levels of drinking. Naltrexone, in both pill and injection, is already approved for use in AUD. The blood levels of naltrexone in these formulations result in an effective blockade of one type of opioid receptor (mu) in the brain, which is thought to contribute to the ability of naltrexone to reduce alcohol consumption and craving. However, the blockade of another opiate receptor (delta) that contributes to the pleasurable effects of alcohol is much lower and highly variable.