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Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence.

Publication ,  Journal Article
Mannelli, P; Patkar, AA; Peindl, K; Murray, HW; Wu, L-T; Hubbard, R
Published in: J Clin Psychopharmacol
October 2007

BACKGROUND: The clinical use of naltrexone (NTX) in the treatment of opioid dependence has been limited because of poor compliance and inconsistent outcomes. In particular, the therapeutic benefit of extended treatment with NTX after opioid detoxification is unclear. The present study evaluated whether the augmentation with low-dose NTX during the post-detoxification treatment of opioid dependence would improve outcomes. METHODS: In an open-label naturalistic design, 435 opioid-dependent patients who had completed inpatient detoxification were offered the choice of entering 1 of the 2 outpatient treatment arms: clonidine extended treatment (CET) (clonidine + psychosocial treatment), or enhanced extended treatment (EET) (oral NTX [1-10 mg/d] + CET) for 21 days. The primary outcome measure was retention in treatment. Secondary outcomes included abstinence from opioids, dropouts, and adherence to postdischarge care. RESULTS: One hundred sixty-two patients (37.2%) accepted EET. Subjects receiving EET stayed longer in the program (F = 64.4; P = 0.000), were less likely to drop out, used less opioids, and followed through with referral to long-term outpatient treatment in a higher number, compared with patients in the CET arm (P = 0.000 in each case). The NTX + clonidine combination was safe and well tolerated. CONCLUSIONS: This preliminary study indicates the potential benefit of augmentation with low-dose NTX to improve outcomes after opioid detoxification for a preferred group of patients. Randomized controlled trials are necessary to further evaluate the role of low-dose NTX in the outpatient treatment of opioid dependence.

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Published In

J Clin Psychopharmacol

DOI

ISSN

0271-0749

Publication Date

October 2007

Volume

27

Issue

5

Start / End Page

468 / 474

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Substance Withdrawal Syndrome
  • Psychotherapy
  • Psychiatry
  • Patient Compliance
  • Opioid-Related Disorders
  • Narcotic Antagonists
  • Naltrexone
  • Male
  • Humans
 

Citation

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Mannelli, P., Patkar, A. A., Peindl, K., Murray, H. W., Wu, L.-T., & Hubbard, R. (2007). Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence. J Clin Psychopharmacol, 27(5), 468–474. https://doi.org/10.1097/jcp.0b013e31814e5e9d
Mannelli, Paolo, Ashwin A. Patkar, Kathleen Peindl, Heather W. Murray, Li-Tzy Wu, and Robert Hubbard. “Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence.J Clin Psychopharmacol 27, no. 5 (October 2007): 468–74. https://doi.org/10.1097/jcp.0b013e31814e5e9d.
Mannelli P, Patkar AA, Peindl K, Murray HW, Wu L-T, Hubbard R. Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence. J Clin Psychopharmacol. 2007 Oct;27(5):468–74.
Mannelli, Paolo, et al. “Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence.J Clin Psychopharmacol, vol. 27, no. 5, Oct. 2007, pp. 468–74. Pubmed, doi:10.1097/jcp.0b013e31814e5e9d.
Mannelli P, Patkar AA, Peindl K, Murray HW, Wu L-T, Hubbard R. Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence. J Clin Psychopharmacol. 2007 Oct;27(5):468–474.

Published In

J Clin Psychopharmacol

DOI

ISSN

0271-0749

Publication Date

October 2007

Volume

27

Issue

5

Start / End Page

468 / 474

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Substance Withdrawal Syndrome
  • Psychotherapy
  • Psychiatry
  • Patient Compliance
  • Opioid-Related Disorders
  • Narcotic Antagonists
  • Naltrexone
  • Male
  • Humans