Low dose naltrexone may be effective in pain management (or not), but DMARDs like Methotrexate actually reduce immune system signaling that causes the widespread inflammation that is the primary source of your pain. If you use opioids to reduce pain, you’re still not addressing the joint destruction being caused by the disease. The inflammation caused by PsA also affects multiple systems in your body, even without causing pain. Ultimately, the decision lies entirely with you, as it is your body and your disease. But I would recommend against anything that does not actually address the inflammation.