The British Journal of Psychiatry (2009) 194: 541-546. doi: 10.1192/bjp.bp.108.055319
© 2009 The Royal College of Psychiatrists
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Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial

Nikolaj Kunøe and Philipp Lobmaier, MD

Norwegian Centre for Addiction Research, Oslo

John Kåre Vederhus, RN and Bjørg Hjerkinn, MD

Addiction Unit, Sørlandet Hospital, Kristiansand

Solfrid Hegstad, PhD

Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, Oslo, Norway

Michael Gossop, PhD

National Addiction Centre, Maudsley Hospital, and Institute of Psychiatry, King's College London, UK

Øistein Kristensen, MD

Addiction Unit, Sørlandet Hospital, Kristiansand

Helge Waal, MD

Norwegian Centre for Addiction Research, Oslo, Norway

Correspondence: Nikolaj Kunøe, Norwegian Centre for Addiction Research, Kirkeveien 166, NO-0407 Oslo, Norway. Email: nikolaj.kunoe{at}medisin.uio.no

Declaration of interest

None.

Background

Naltrexone has considerable potential in helping to prevent relapse in heroin dependency. A longer-lasting formulation for naltrexone treatment is desirable to further reduce non-adherence and relapse during treatment of opiate dependence.

Aims

To evaluate the safety and effectiveness of a 6-month naltrexone implant in reducing opioid use after in-patient treatment.

Method

A group of 56 abstinence-oriented patients who completed in-patient treatment for opioid dependence were randomly and openly assigned to receive either a 6-month naltrexone implant or their usual aftercare. Drug use and other outcomes were assessed at 6-month follow-up.

Results

Patients receiving naltrexone had on average 45 days less heroin use and 60 days less opioid use than controls in the 180-day period (both P<0.05). Blood tests showed naltrexone levels above 1 ng/ml for the duration of 6 months. Two patients died, neither of whom had received an implant.

Conclusions

Naltrexone implant treatment safely and significantly reduces opioid use in a motivated population of patients.


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Naltrexone Implants
Kathleen I Kelly, et al.
BJP Online, 30 Sep 2009 [Full text]
Re: Naltrexone Implants
Nikolaj Kunĝe, et al.
BJP Online, 22 Oct 2009 [Full text]