My GP Said No to Naltrexone. What Now?
By Matt Brindley.
You did the hard part.
You picked up the phone, booked the appointment, sat in the waiting room... And spoke honestly to another human being (potentially for the first time ever), about your drinking, how hard you are finding things, and that life is starting to feel a bit heavier because of it.
You opened up, and the answer was no.
That can feel like a punishment... You put it all out there for nothing. It can feel like a door shutting... Especially if it took you months, or years, to ask.
It isn't. We need some perspective, and a plan.
Maybe you asked for naltrexone by name.
Maybe you asked about your options, and medication wasn't offered.
Either way, the next steps are the same.
In short
A no is common, and it's usually about how the NHS is set up, not about you.
Know which "naltrexone" you asked about. The NHS uses it daily to help you stay stopped. The Sinclair Method uses it while you're still drinking. Most GPs say no to the second, not to helping you.
You can often refer yourself to your local alcohol service, free, without your GP.
You can ask to see another GP, or go back better prepared.
...Our free guide, Before You See Your GP, shows you how.Private prescribing is a real, legal route, if you check the prescriber properly, and the support that comes with it.
Please don't stop or cut down sharply on your own if your body depends on alcohol. Get medical advice first.
Why did my GP say no?
It's rarely about you.
Naltrexone can be used in:
Two completely different ways, with
Two completely different journeys, for
Two completely different goals.
On the NHS, it's usually a daily medicine to help you stay stopped, once you've already stopped drinking. That's how it's licensed in the UK.
The Sinclair Method uses it while you're still drinking, so over time the desire for alcohol weakens and your drinking comes down. That's outside naltrexone's UK licence.
Other considerations:
Your GP is a generalist by design. Alcohol treatment is a specialist field, and many areas route these medicines through specialist services, not GPs. That's how the NHS is set up to care for patients.
Off-label means personal responsibility. A GP who prescribes outside the licence takes responsibility for it. Many choose not to, not because they don't care; because it isn't their specialist field.
Cutting down while you keep drinking needs eyes and ears. Someone keeping an eye on it, week by week. Short GP appointments, weeks apart, aren't built for that.
So a GP saying "I'm not comfortable prescribing it that way" is a reasonable, professional answer.
...The full picture is in Can I get naltrexone from my GP or the NHS?
What can I do now?
1. Ask what they'd suggest instead
And ask for it to be noted on your record, so the conversation can carry on next time.
Your GP might offer a referral, talking therapies, or a different medicine. Acamprosate is the other first-choice medicine for staying stopped. Nalmefene is licensed to help some people cut down. Whichever it is, it comes with support alongside, often from your local specialist alcohol service, so your GP may refer you on. A doctor decides whether any of them suit you.
2. Refer yourself to your local alcohol service
Most people don't know they can.
It took me about six months to make that call. I was petrified of bumping into someone I knew, so I went to the branch in the next town.
If that's you... It's normal. Make the call anyway.
In many areas of England you don't need your GP at all. These services are free, confidential, and specialists in exactly this. Find yours on the NHS website. In Scotland, Wales and Northern Ireland, Alcohol Change UK lists local services.
3. Ask to see another GP
You can ask to see a different GP at your practice. Some are more familiar with medicines for alcohol than others.
4. Go back better prepared
Ask for a follow-up appointment, and keep a drinking diary for two weeks before it. Our units calculator turns it into numbers, and its three AUDIT-C questions are the same short check many GPs use.
Real numbers move conversations on.
...Take our free guide with you: Before You See Your GP. Your numbers, what to say, the questions worth asking, and a checklist to screenshot. No sign-up. No follow-up from us.
5. Look at a private prescriber
A private prescriber can assess you and, if they decide it's suitable, prescribe naltrexone for The Sinclair Method. That's legal. Before you choose one, check:
who the prescriber is, and that they're registered (the GMC, for doctors);
that they assess your health properly first, including your liver, any opioid medicines, and whether your body depends on alcohol;
what the consultation and the medicine each cost;
what support comes with it, and who keeps an eye on you while your drinking comes down.
That last one matters more than most people think.
In the key trial of naltrexone used this way, it made the biggest difference for people who also had coping-skills sessions: 27% had no return to heavy drinking over 32 weeks, against 3% on a placebo. With only general support, it didn't beat the placebo at all (Heinälä and colleagues, 2001).
Same medicine. Different support. Different result.
Over time, the medicine can quieten the desire...
But the habits, the routines and the moments you've built around a drink over years... That's the work. And it's where support makes the difference.
Should I tell my GP? Yes, if you can. Your GP holds your full medical history, and a good private prescriber will ask about it.
Can't I just buy naltrexone online?
No.
It's prescription-only in the UK. Sites that sell it without a proper consultation skip the safety checks, and may sell fakes.
What if I don't want medication at all?
That's a valid choice.
Local alcohol services, talking therapies, support groups and coaching all help people change their drinking without medicine. Every route, side by side, is in our guide to alcohol treatment in the UK.
Whatever happens, talk to someone today
You don't have to have it all worked out.
Drinkline, the national alcohol helpline, is free and confidential: 0300 123 1110.
A no from one GP, on one day, isn't the end of this. Asking was the start.
If you'd like support from us
Rethink Drink is a UK coaching service built around The Sinclair Method. Our programmes include a consultation with an independent prescribing doctor, who decides whether treatment is suitable for you. Any prescription is dispensed by an independent partner pharmacy. Our coaches work with you, week by week, on everything around it.
Please look after yourself
This page is here to help you understand your options. It isn't medical advice, and it can't replace a conversation with a doctor who can ask qualifying questions.
If you drink every day, or you get shaky, sweaty or anxious when you stop, speak to a doctor or your local alcohol service before you change how much you drink.
If you or someone else has a seizure, confusion, or sees or hears things that aren't there after stopping or cutting down, call 999.
I really hope this post helps. If you have any questions, you can contact me here.
Matt
Sources
Department of Health and Social Care. UK clinical guidelines for alcohol treatment, chapter 10.
General Medical Council. Prescribing unlicensed medicines.
Heinälä P and colleagues. Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence. Journal of Clinical Psychopharmacology, 2001.
Alcohol Change UK. Get help now.
