Anything involving an antagonist is going to reduce tolerance and the overdose deaths I have heard of were associated with rapid opioid detoxification, so naltrexone in theory can do the same thing. People do take tiny doses of naltrexone, naloxone, and in some cases nalorphine along with narcotic analgesics to slow down development of tolerance and it works through the antagonist kicking opioid molecules off of a certain absolute number of receptors which is miniscule compared to the number of receptors being agonised by the painkiller.
The buprenorphine causes precipitated withdrawal by, as a partial μ opioid agonist, occupying close to 100 per cent of those receptors and having a high affinity for them, and antagonising the κ and δ opioid receptors. I think that reintroducing nalorphine and it esters as medications that can be prescribed and mixed into combination products would be very helpful -- nalorphine has agonist as well as antagonist activity and may be good in like a Suboxone for people wanting to get clean, get maintained, or kick down but also have diagnosed severe pain; another narcotic invented in 1966 but lost in the mists of time, myrophine, 3-acetyl, 6-myristylmorphine, probably does that job better than buprenorphine so a myrophine-nalorphine mixture would be even better.
Kratom having actions which are different in some respects than morphine, for example, and certainly ones which are unknown, probably some activity not considered narcotic and therefore it will be impacted less by opioid antagonists, to a degree that varies from one person to another. I had indeed wondered if the differences amongst naltrexone, naloxone, nalmefene, nalorphine, diprenorphine, nalorphine dinicotinate, nalodeine &c may allow various agonists to get some work done via the δ opioid receptor, as well as the newly discovered ζ opioid receptor, and the ones suspected to exist that I am sure they will find soon (λ, ε, θ, ι, ξ, φ, ψ, χ, γ, β, α opioid and still others) and some narcotic painkillers which work with the antinociceptive and NMDA systems, opioid-like receptor, and the σ receptor . . . then there is the μ₃ opioid receptor, a type of receptor which seems to work only with morphine and appears to have developed along with the body's ability to make morphine endogenously . . . then other agents with higher affinities than the antagonists and partial agonists, and above a certain level of affinity agonise the receptors to a different and greater degree, like 14-methoxymetopon, which appears to actually, literally, stick a part of its molecule deeper into the μ₁ and μ₂ opioid receptors and may agonise the μ₃ opioid receptor to a notable degree . . . there may be some fentanils, ampromides, benzimidazoles, bridged oripavine derivatives, morphazones, and other 14-dihydromorphinone opioids which can do this also . . .
A while ago, there was this kid everyone called Deeper; his given name may have been Deepak or something similar. One night, he stays after school for running in the hallway and at the end as he was getting ready to leave, he asked the teacher, Ms Take, if she would take off her clothes . . . he figured there were even odds on it, given that earlier in the day when there were not enough pinballs and marbles to go around when doing experiments with inclined planes, she got out some Ben Wa Balls.
"No, that is not a good idea" she said
-- Please, just for me?
She got a frisson from the transgression and subversion it would be, and decided she would do it, after all Deeper was one of the more diligent and tractable students
"skirt too"
--Why
"Just for me?"
-- Well, OK
So this continues for a short time, then Deeper picks up a 45-cm ruler and says:
"Can I stick this ruler up your arse?"
-- No
"Please, just for me?"
So in goes the ruler, and it was cold and quite a bit of shock & awe set in almost instantaneously.
"Deeper! Deeper!" she yelled