Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial.

Published

Journal Article

Although current treatments for opioid detoxification are not always effective, medical detoxification remains a required step before long-term interventions. The use of opioid antagonist medications to improve detoxification has produced inconsistent results. Very low dose naltrexone (VLNTX) was recently found to reduce opioid tolerance and dependence in animal and clinical studies. We decided to evaluate safety and efficacy of VLNTX adjunct to methadone in reducing withdrawal during detoxification. In a multi-center, double-blind, randomized study at community treatment programs, where most detoxifications are performed, 174 opioid-dependent subjects received NTX 0.125 mg, 0.250 mg or placebo daily for 6 days, together with methadone in tapering doses. VLNTX-treated individuals reported attenuated withdrawal symptoms [F = 7.24 (2,170); P = 0.001] and reduced craving [F = 3.73 (2,107); P = 0.03]. Treatment effects were more pronounced at discharge and were not accompanied by a significantly higher retention rate. There were no group differences in use of adjuvant medications and no treatment-related adverse events. Further studies should explore the use of VLNTX, combined with full and partial opioid agonist medications, in detoxification and long-term treatment of opioid dependence.

Full Text

Duke Authors

Cited Authors

  • Mannelli, P; Patkar, AA; Peindl, K; Gorelick, DA; Wu, L-T; Gottheil, E

Published Date

  • April 2009

Published In

Volume / Issue

  • 14 / 2

Start / End Page

  • 204 - 213

PubMed ID

  • 18715283

Pubmed Central ID

  • 18715283

Electronic International Standard Serial Number (EISSN)

  • 1369-1600

Digital Object Identifier (DOI)

  • 10.1111/j.1369-1600.2008.00119.x

Language

  • eng

Conference Location

  • United States