Why Is Naltrexone So Hard to Find? [Explained for 2026]

If your pharmacist has told you that naltrexone is out of stock — or if you've been calling around trying to find it — you are not alone. Since early 2024, naltrexone tablets have been caught in an active shortage that has frustrated patients, providers, and pharmacies across the country. In 2026, the situation has improved somewhat, but supply remains inconsistent depending on where you live and which pharmacy you use.

This article explains what's behind the naltrexone shortage, who it affects most, and — most importantly — what you can do right now to find naltrexone in stock near you.

What Is Naltrexone and Why Does It Matter?

Naltrexone is an FDA-approved medication used to treat two of the most serious substance use disorders in the United States: alcohol use disorder (AUD) and opioid use disorder (OUD). It works by blocking opioid receptors in the brain, which removes the rewarding "high" from opioids and dulls the pleasurable effects of alcohol. This makes it a cornerstone of medication-assisted treatment (MAT) programs.

Unlike methadone or buprenorphine, naltrexone is not a controlled substance, which means any licensed provider — your primary care doctor, a nurse practitioner, or a telehealth provider — can prescribe it without special licensing or a DEA waiver. This accessibility makes it especially important: it is one of the most democratic treatments available for substance use disorders.

Naltrexone comes in two main forms: a 50 mg oral tablet taken once daily, and Vivitrol, a 380 mg extended-release injection administered once a month by a healthcare provider. The oral tablet is available only as a generic (brand-name ReVia and Depade have been discontinued). Vivitrol, the injectable form, has not been affected by the current shortage.

Is Naltrexone Really in Shortage in 2026?

Yes. The American Society of Health-System Pharmacists (ASHP) and Drugs.com both list naltrexone hydrochloride tablets as subject to an active drug shortage that was first reported in February 2024. Multiple manufacturers have either discontinued their naltrexone products or reported limited availability through 2026.

Some manufacturers — including Accord, Major, and Sun — still have product available, which means naltrexone is not completely gone from the market. But the shortage is uneven: your local CVS or Walgreens may be fully stocked while the independent pharmacy two blocks away has nothing on the shelf. This patchwork availability is what makes finding naltrexone so frustrating for patients.

What Is Causing the Naltrexone Shortage?

The naltrexone shortage is the result of several compounding problems:

1. Demand Has Surged

The COVID-19 pandemic led to a dramatic rise in alcohol consumption across the United States, and that increase in alcohol misuse has translated into a surge in demand for AUD medications like naltrexone. On top of that, increased awareness of medication-assisted treatment — driven by public health campaigns and expanded telehealth access — has brought more patients into treatment. Naltrexone was the 254th most-prescribed drug in 2021, a ranking that would look very different today.

2. The Active Ingredient Is Tightly Regulated

Naltrexone is synthesized from thebaine, a naturally occurring compound derived from the opium poppy plant. Thebaine is also used to make other, more profitable medications including hydrocodone, oxycodone, buprenorphine, and naloxone. Because thebaine can theoretically be used to produce addictive substances, the DEA strictly regulates how much can be imported annually. This puts naltrexone in direct competition with higher-margin opioid medications for a limited pool of raw ingredient — and naltrexone usually loses out.

3. Low Profit Margins Mean Low Priority

A 30-day supply of generic naltrexone tablets costs around $32 to $90 at most pharmacies — even without a coupon. That's inexpensive by medication standards, which means manufacturers earn less per unit than they do from other drugs. When raw ingredient is scarce, drug makers tend to prioritize products that generate higher revenue. Naltrexone's low profit margin puts it at the back of the production line.

4. Manufacturing Takes Time

Naltrexone tablets are complex to manufacture — it can take six months or more to produce a new batch from start to finish. Even when manufacturers commit to ramping up production, the effects aren't felt at pharmacies for months. This long production cycle means shortages can persist long after the underlying cause has been addressed.

5. Manufacturers Have Been Exiting the Market

Multiple manufacturers — including Avet Pharmaceuticals and Tagi Pharma — have permanently discontinued their naltrexone tablet products. Each manufacturer exit reduces the total supply buffer available to pharmacies nationwide.

Who Is Most Affected by the Naltrexone Shortage?

The shortage disproportionately affects:

Patients taking oral naltrexone daily for alcohol use disorder — stopping suddenly can destabilize recovery.

Patients using naltrexone for opioid use disorder who are newly starting treatment — delays in starting can lead to relapse.

Patients in rural areas with fewer pharmacy options.

Patients using low-dose naltrexone (LDN) for off-label conditions, since compounding pharmacy supplies have also been strained.

What About Vivitrol? Is the Injectable Affected?

Vivitrol — the brand-name 380 mg injectable extended-release naltrexone — has not been significantly affected by the current shortage. Alkermes, the manufacturer of Vivitrol, credits its multi-year production planning cycles for allowing it to avoid the supply disruptions seen with generic oral tablets. For patients who qualify and whose insurance covers it, Vivitrol may be a viable alternative to oral tablets during the shortage. However, Vivitrol typically costs $1,200 or more per monthly injection without insurance, and requires administration by a healthcare provider.

What Can You Do If You Can't Find Naltrexone?

Here are the most effective steps to take right now:

Call multiple pharmacies.

Availability varies dramatically from one pharmacy to the next, even within the same zip code. Independent pharmacies, grocery chain pharmacies, and big-box retailers may have stock when chain pharmacies are out.

Use medfinder to locate in-stock pharmacies.

medfinder.com calls pharmacies in your area to check which ones have your medication in stock, then texts you the results. This saves you hours of phone calls during a shortage.

Ask your prescriber about Vivitrol.

If you are struggling to find oral tablets, ask whether the injectable form might be appropriate for you. Vivitrol is more widely available right now.

Ask your prescriber about compounding pharmacies.

Compounding pharmacies can sometimes prepare naltrexone in alternative formats such as capsules or liquids, and may have access to the API when commercial tablets are unavailable. This is especially relevant for patients on low-dose naltrexone (LDN).

Don't stop taking naltrexone abruptly without guidance.

While naltrexone is not physically addictive, stopping suddenly during recovery can increase the risk of relapse. Contact your prescriber if you are running low so you can make a plan.

Will the Naltrexone Shortage Resolve?

The shortage is ongoing as of 2026, though some manufacturers have indicated additional supply is expected. The long-term outlook depends on DEA quotas for thebaine, whether manufacturers invest in production capacity, and whether demand growth stabilizes. In the meantime, patients need to be proactive about locating their supply.

For the latest shortage updates and patient-specific advice, see our guide: Naltrexone Shortage Update: What Patients Need to Know in 2026.

Also helpful: How to Find Naltrexone in Stock Near You (Tools + Tips).