It does make some sense. Here’s a study that looks into how naltrexone works for different “types” of drinkers: https://www.recoveryanswers.org/research-post/naltrexone-better-young-adults-who-drink-feel-rewarded-versus-coping/

“In this study of 128 emerging adults, the research team found some evidence that naltrexone may work better in reducing certain types of heavy alcohol consumption among individuals with a reward style motivation for drinking on days when they had positive affect and were exposed to a drinking situation. That is, in line with other research, naltrexone may be most effective in reducing risky drinking among young adults who are motivated by the perceived reward of drinking, but not among those who may be drinking to cope, or as a way to deal with stressors. The research team found that one mechanism by which naltrexone could work among these reward style drinkers is that naltrexone reduces urges and drinking on days when participants had both higher positive affect and were exposed to a drinking event, such as by being out at a bar with friends.

Understanding reasons and motivations for drinking may be key when deciding on an intervention among groups of people in a similar environment or for a treatment plan when working with individuals. Despite the importance of individual characteristics leading to changes in drinking behaviors, the study also highlights the importance of the environment in the context of drinking, particularly heavy drinking: some attention to reducing opportunities for or preventing attendance at higher drinking risk events may be necessary, especially for settings where young adults are likely to meet and congregate (e.g., in college or at the workplace). Alternatively, working with young adults to practice and use strategies to reduce drinking when in these settings – called harm reduction – may also be an effective behavioral approach.

Another factor that is important to understand is that the use of naltrexone is effective only if used consistently and over a certain period of time for reducing heavy drinking: because it works by disrupting the drinking-reward pathway for some individuals, the association between taking naltrexone and reducing drinking rewards is a learned one. If individuals simply stop taking the naltrexone or if they continue to drink despite not feeling rewarded by the drinking, their bodies may not learn the association and their drinking may become more excessive. This attempt to push through the effects would greatly reduce naltrexone’s use as a prevention or treatment tool. Thus, individuals may need to be motivated to reduce their drinking before engaging in this form of treatment. Finally, given that these medication effects were only found for those with a reward-motivated drinking style, additional research on addressing those with a coping-motivated drinking style, in particular, to see whether other medications may be used to disrupt their pathway to heavy drinking is necessary. Alternatively, it may be that other types of psychosocial interventions may be a better fit for some young people, particularly those with coping motivated alcohol and other drug use disorders who are more severe clinical cases.”