I find it interesting I can't seem to find any topics related to naltrexone and harmalas. Naltrexone has a 28 day intramuscular injection sustained release formulation (vivitrol). Naltrexone is an opioid receptor antagonist. It apparently also reduces cravings for most drugs especially drugs with downstream endorphin effects. It is given to opioid addicts and alcoholics primarily but it also shows decreased frequency of behaviors that release natural endorphins like overeating, masturbation, gambling, and kleptomania.
Naltrexone is active on its own but is metabolized in the liver by dihydrodiol dehydrogenases into 6β-naltrexol and 2-hydroxy-3-methoxy-6β-naltrexol and 2-hydroxy-3-methoxynaltrexone. Naltrexone isn't metabolized by the cytochrome p450 system and has a low potential for drug interaction.
I wonder, since ayahuasca can provide valuable insight and healing to those who have struggled with addiction and gone through residential treatment, intensive outpatient, etc. which is mainly concerned with healing trauma and implementing healthy lifestyle practices but it can't heal it all.. I wonder if after extensive therapy and healing and change has occured if ayahuasca is a viable tool to continue to dig deeper?
I gave a forward of some basic pharmacokinetics of naltrexone because many people especially alcoholics and opioid addicts start getting vivitrol injections monthly for months to years after completing treatment programs and were someone to stop the injections early in order to drink ayahuasca they also have a window where opioids would work and alcohol wouldn't be as sickening to consume and cravings and addictive behaviors may begin to resurface and a relapse could likely mean death as the addicts no longer have any tolerance to opioids and the quantity of fentanyl on the street only seems to be increasing. On the surface it appears like it could be safe in combination with ayahuasca.
I've been thinking about and researching this topic for some time now and figure I would put my inquiry out into the aether as I know some of you have access to resources I do not.
For those of you who are just curious but cannot view research papers because they are all behind fking paywalls...
https://www.sci-hub.st/ will help you get around many (not all)