Naltrexone is used in the treatment of alcohol dependence. The mechanism by which it reduces alcohol craving and consumption is:

• A By activating mu-opioid receptors to substitute for alcohol's reinforcing effects
• B By inhibiting aldehyde dehydrogenase, producing an aversive reaction with alcohol
• C By blocking mu-opioid receptors, reducing the endorphin-mediated reward from alcohol ✓
• D By enhancing GABAergic transmission in the reward pathway

Explanation

Naltrexone is a competitive opioid receptor antagonist that blocks mu receptors, reducing the endorphin-mediated pleasurable effects of alcohol consumption. This attenuates craving and reinforces abstinence. Option B describes disulfiram. Naltrexone is also used for opioid overdose reversal but requires caution in patients on opioid therapy as it precipitates withdrawal.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

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