Optimising Patient Care Using Naltrexone for Opioid Use Disorders

Le résumé fourni par la source

The opiate antagonist naltrexone (NTX) was specifically developed as a possible alternative to methadone maintenance for treating opiate dependence. Though it can completely block the agonist effects of even very large doses of opiates, poor compliance with oral NTX limited its potential. However, since the late 1990s, long-acting depot and implanted NTX (DINTX) preparations have increasingly demonstrated a clinically significant contribution to the treatment menu. As well as summarising the controlled studies that confirm that contribution, this chapter examines its theoretical underpinnings and their practical implications. Clinicians using DINTX will benefit from familiarity with the much larger evidence base for an addiction treatment that involves very similar (if often unrecognised) similarities with DINTX: long-term supervised disulfiram for alcoholism combined with community reinforcement programmes. After noting some medico-political disputes that have delayed its acceptance and use, the chapter explains how the main pharmacological obstacle to DINTX treatment – the conventional requirement for several days of complete abstinence from opiate agonists before initiating antagonist therapy – can be easily overcome by well-established techniques using various levels of sedation that guarantee 100% induction rates, minimise withdrawal distress and avoid the high drop-out and failure rates of conventional methods.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.