Evidence reviewed
Canada
Health Canada-authorised oral naltrexone is available in generic form and CAMH recommends it as a first-line treatment for alcohol use disorder. Coverage, eligibility, and patient cost vary by province and plan; check the current product-specific formulary entry before treatment.
Canada recognises naltrexone as a first-line medication for alcohol use disorder. The Centre for Addiction and Mental Health (CAMH) — Canada's largest mental health teaching hospital — recommends naltrexone as the preferred pharmacotherapy, noting that it can be prescribed while patients are still drinking and does not require abstinence before initiation.
Naltrexone is approved by Health Canada and available in generic form under multiple brand names: Apo-Naltrexone (Apotex), ReVia (Bausch Health), and Naltrexone Hydrochloride Tablets USP (various generic manufacturers). The Ontario Drug Benefit formulary lists these products at CAD $2.8075 per 50 mg tablet (the amount the Ministry of Health pays).
Provincial and territorial drug plans determine coverage individually, and requirements can change. CAMH guidance describes an Ontario Limited Use pathway, while the live Ontario formulary results checked 26 July 2026 list naltrexone products as General Benefit. Patients and prescribers should verify the current product-specific entry rather than rely on a single national coverage statement. Canada also has Rapid Access Addiction Medicine (RAAM) clinics that may provide walk-in addiction care, including naltrexone assessment and prescribing.
Multiple pathways may be available through Canada's provincial healthcare systems.
A family doctor can assess alcohol use and prescribe naltrexone. CAMH guidance explicitly supports primary-care prescribing. Before dispensing, the prescriber or pharmacist should check the current provincial benefit status, eligibility rules, and stock for the exact product.
Rapid Access Addiction Medicine clinics provide low-barrier addiction care in several provinces. Services, hours, referral requirements, and same-day prescribing vary by location, so verify the local clinic before travelling.
For complex cases or consideration of injectable naltrexone, referral to an addiction medicine physician or psychiatrist may be appropriate. Provincial coverage, referral requirements, and waiting times vary by region and service.
Some clinicians offer telephone or video consultations for assessment and follow-up. Availability, prescribing rules, and any patient charge depend on the province, provider, and clinical circumstances.
| Province/Territory | Coverage type | |
|---|---|---|
| Ontario | The live Ontario Drug Benefit results checked 26 July 2026 list 50 mg naltrexone products at CAD $2.8075 per tablet and show General Benefit. CAMH's clinical guidance still describes an older Limited Use pathway, so verify the current product detail. | Live listing: General Benefit |
| British Columbia | Coverage and eligibility should be checked in the current BC PharmaCare formulary and against the patient's plan before prescribing or dispensing. | Verify current record |
| Alberta | Coverage and eligibility should be checked in the current Alberta Drug Benefit List. Alberta Health Services also operates addiction services, but local access varies. | Verify current record |
| Quebec | Check the current RAMQ Liste des médicaments for product status, eligibility, and patient contribution. | Verify current record |
| All other provinces and territories | Coverage details and authorization mechanisms vary. Contact the relevant public drug plan or insurer and verify the exact product before relying on reimbursement. | Varies |
Coverage is province- and plan-specific. Ontario's live formulary provides a useful current product price and benefit-status record, but it should not be generalised to every resident or province.
It is a formulary mechanism that limits public reimbursement to specified criteria. A prescriber checks and records the applicable code; approval and patient charges depend on the current provincial rules. Current Ontario product results should be checked because they do not match CAMH's older Limited Use description.
This audit did not establish a current marketed product and nationwide stock record strongly enough to promise availability. Ask Health Canada, the provincial formulary, the prescriber, and the dispensing clinic about the exact product.
Primary-care prescribing is supported in Canadian clinical resources, but individual assessment, local practice, and product availability still apply.
Start with a primary-care clinician or use Health Canada's treatment-service directory to find an appropriate local service. Eligibility, referral requirements, availability, and patient charges vary by province and provider.
Primary-care prescribing guidance and the older Ontario Limited Use description.
Live product, price, interchangeability, and current benefit-status records; checked 26 July 2026.
National treatment-service starting point.
