Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-29T07:13:42.017Z Has data issue: false hasContentIssue false

Naltrexone implants

Published online by Cambridge University Press:  02 January 2018

Kiriakos Xenitidis
Affiliation:
Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, UK. Email: kathleen.kelly@obmh.nhs.uk
Colin Campbell
Affiliation:
Special Community Addictions Service, Oxford, UK
Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2010 

In the first randomised controlled trial of naltrexone implants, Kunøe et al Reference Kunøe, Lobmaier, Kåre Vederhus, Hjerkinn, Hegstad and Gossop1 identify two inclusion criteria in their methodology: being an in-patient and being 18 years or above. Exclusion criteria are given as psychosis, pregnancy and serious hepatic disease. Of 667 possible participants, 480 are excluded. In the results, the term ‘ineligibility’ is used to describe not completing treatment, starting maintenance and transfer to other clinics. Could the authors clarify when these additional criteria were decided upon and how many were excluded for each reason? Given that all 667 patients were receiving ‘abstinence-oriented’ in-patient treatment, it is notable that only a small proportion of patients was eligible for or wanted such treatment. The characteristics of the ineligible or refusal group could provide important information about which group of opiate-dependent patients are likely to benefit from naltrexone.

Data on opioid use throughout the period of treatment would be of value. In the non-abstainers we would expect both groups to use in the first few days, but behavioural extinction to occur in the naltrexone group.

Participants who had their implants removed were included in the analysis using their last response carried forward. If these patients could not be contacted, would it not be a more conservative assumption that they would have relapsed?

The patient group that was living in a controlled environment (prison or clinic) at follow-up was dealt with by using pre-admission data. This group is missing from the flowchart.

Footnotes

Edited by Kiriakos Xenitidis and Colin Campbell

References

1 Kunøe, N, Lobmaier, P, Kåre Vederhus, J, Hjerkinn, B, Hegstad, S, Gossop, M, et al. Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial. Br J Psychiatry 2009; 194: 541–6.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.