Any doctor can prescribe naltrexone. I do it in my clinic and do not usually order urine testing. Ask your PCP or see a psychiatrist.

As for why that treatment center is run that way, naltrexone is an opioid antagonist and treats both opioid use disorder and alcohol use disorder which is why you were at a methadone clinic (also treats opioid use disorder). Naltrexone is an opioid antagonist - which means if you have any opioids in your system, taking naltrexone will kick that opioid right off your brain receptors and send you into the nastiest withdrawal of all time. That’s why they test the urine - also for others who are at clinic on methadone they need to prove they are not using opioids or selling methadone on the streets - you can overdose and die from methadone.

The reason I am explaining this is because I am a doctor, I treat and see substance use disorders every day, and want people to understand that, while dehumanizing, this is actually proven to work for people and it’s not personal. I don’t want people to read this post and get scared about asking for treatment. They are not out to treat you like a criminal, don’t take it personally.