Abstract:
:Early relapse is common after opiate withdrawal and deprives addicts of important opportunities to develop new, opiate-free cognitive-behavioural habits. The oral opiate antagonist naltrexone (NTX) significantly reduces relapse only when rigorously supervised and/or probation-linked. Simple but effective NTX implants, containing 1G NTX and giving an average blockade of 6 - 7 weeks, have been available since 1997. We present outcome data for two cohorts. Group 1 were the first 55 consecutive implanted British patients (76% male, 51% unemployed, 64% in social classes III - V). Group 2 were a second consecutive group of 46. Implants were inserted subcutaneously mainly during rapid opiate detoxification under general anaesthesia or sedation. The follow-up rate for group 1 was 100%. At 12 weeks after first implantation, 21% of group 1 patients and 26% of group 2 patients had apparently resumed opiate use. Thirty per cent of patients tested-out the blockade in the first week. None reported any opiate effects at less than 5 weeks after insertion. In other patients, typical blood NTX levels 4 - 5 weeks post-insertion were in the range 3 - 5 ng/ml, which is evidently enough to block 500 mg of pure diamorphine. NTX implants provide considerable protection against early relapse and may increase the likelihood of therapeutically useful periods of abstinence after opiate withdrawal. Troublesome tissue reactions were infrequent. Improvements in implant technology and duration are already occurring. We stress that implants strengthen rather than replace the therapeutic alliance.
journal_name
Addict Bioljournal_title
Addiction biologyauthors
Foster J,Brewer C,Steele Tdoi
10.1080/1355621031000117446subject
Has Abstractpub_date
2003-06-01 00:00:00pages
211-7issue
2eissn
1355-6215issn
1369-1600pii
78WFVBP273F5Q4N7journal_volume
8pub_type
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journal_title:Addiction biology
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pub_type: 杂志文章
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journal_title:Addiction biology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Addiction biology
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journal_title:Addiction biology
pub_type: 杂志文章,多中心研究
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journal_title:Addiction biology
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journal_title:Addiction biology
pub_type: 杂志文章,随机对照试验
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