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The use of naltrexone, an opiate antagonist, in the treatment of opiate addiction

  • Conor K Farren (a1)


Objective: The objective of this article is to review the use of the opiate antagonist naltrexone as an alternative to opiate agonist maintenance in the treatment of opiate addiction.

Method: An extensive literature search, via Medline, Biosis, Psycinfo and other databases was carried out.

Results: Naltrexone has been used in the treatment of opiate addicts in a variety of settings. A number of methods of induction onto naltrexone of recently abstinent addicts have been used in different settings. Naltrexone has had a wide range of outcome success with different populations and associated treatment regimes.

Conclusions: The benefits of naltrexone can be compared with alternatives such as methadone maintenance and therapeutic communities. Naltrexone can be made more effective in the general population of opiate addicts with the use of adjunctive therapies.



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1.Wilker, A. Recent progress in research on the neurophysiological basis of morphine addiction. Am J Psychiatry 1948; 105: 329–38.
2.Gold, MS, Pottash, ALC, Sweeney, DRet al.Opiate withdrawal using clonidine: a safe, effective, and rapid non-opiate treatment. J Am Medical Assoc 1980; 243: 343–6.
3.Charney, DS, Riordan, CE, Kleber, HD. Clonidine and naltrexone: a safe, effective and rapid treatment of abrupt withdrawal from methadone therapy. Arch Gen Psychiatry 1982; 39: 1327–32.
4.Vinning, E, Kosten, TR, Kleber, HD. Clinical utility of rapid clonidine naltrexone detoxification for opioid abusers. Br J Addictions 1988; 83: 567–75.
5.Brewer, C, Rezae, H, Bailey, C. Opioid withdrawal and naltrexone induction in 48-72 hours with minimal drop out, using a modification of the naltrexone-clonidine technique. Br J Psychiatry 1988; 153: 340–3.
6.Loimer, N, Lenz, K, Schmid, R, Presslich, O. Technique for greatly shortening the transition from methadone to naltrexone maintenance of patients addicted to opiates. Am J Psychiatry 1991; 148: 933–5.
7.Kleber, HD, Riordan, CE, Rounsaville, BJ. Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 1985; 42: 391–8.
8.Kosten, TR. Current pharmacotherapies for opioid dependence. Psychopharmacol Bull 1990; 26(1): 6974.
9.Roth, A, Hogan, I, Farren, CK. Cohesive group therapy and naltrexone for opiate abusing health professionals. J Subst Abuse Treat 1996. In Review
10.Washton, AM, Pottash, AC, Gold, MA. Naltrexone in addicted business executives and physicians. J Clin Psychiatry 1984; 45(2): 3941.
11.Ling, W, Wesson, DR. Naltrexone treatment for addicted health care professionals: a collaborative private practice experience. J Clin Psychiatry 1984; 45 (9, Sec 2): 46–8.
12.Brahen, HS, Henderson, RK, Capone, T, Kondal, N. Naltrexone treatment in a jail work release programme. J Clin Psychiatry 1984; 45(2): 4952.
13.Anton, RF, Hogan, I, Jalai, B, Riordan, CE, Kleber, HD. Multiple family therapy and naltrexone in the treatment of opiate dependence. Drug and Alcohol Dependence 1981; 8: 157–68.
14.Resnick, R, Schuyten-Resnick, E, Washton, AM. Narcotic antagonists in the treatment of opioid dependence: review and commentary. Compr Psychiatry 1979; 20: 116–25.
15.Callahan, EJ. Comparison of two naltrexone programmes: naltrexone alone versus naltrexone plus behaviour therapy. In Julius, D, Renault, P, eds. Narcotic antagonists: naltrexone. NIDA Research Monograph. Washington DC: Supt of Docs, US Govt Print Off 1976; 9: 150–7.
16.Callahan, EJ. The treatment of heroin addiction: naltrexone alone with behavior therapy. Am J Drug and Alcohol Abuse 1980; 7: 795807.
17.Grabowski, J. Effects of contingent payment on compliance with a naltrexone regime. Am J Drug and Alcohol Abuse 1979; 6(3): 355–65.
18.Garcia Alonzo, F, Guttierez, M, San, L, et al.A multicenter study to introduce naltrexone for opiate dependence in Spain. Drug Alcohol Depend 1989; 23(2): 117–21.
19.Lerner, A, Sigal, M, Bacalu, A, Shiff, R, Burganski, I, Gelkopf, M. A naltrexone double blind placebo controlled study in Israel. Isr J Psychiatry Relat Sci 1992; 29(1): 3643.
20.Greenstein, RA, Arndt, IC, McClellan, AT, O'Brien, CP, Evans, B. Naltrexone: a clinical perspective. J Clin Psychiatry 1984; 45: 25–8.
21.Bradford, HA, Hurley, FL, Golondzoeske, O, Dorrier, C. Interim report on clinic intake and safety data collected from 17 NIDA funded naltrexone centers. In: Julius, D, Renault, P, eds. Narcotic antagonists: naltrexone. Rockvilie: NIDA Research Monogram 1975; 9: 163–71.
22.Lowinson, JH, Marion, IH, Joseph, H, Dole, VP. Methadone maintenance. In: Lowinson, JH, Ruiz, P, Millman, RB, Langrod, JG, eds. Substance abuse: a comprehensive textbook. Baltimore: Williams and Wilkins, 1992; 550–61.
23.DeLeon, G, Schwartz, S. The therapeutic community: what are the retention rates? Am J Drug and Alcohol Abuse 1984; 10: 267–84.
24.Higgins, ST, Delaney, DD, Budney, AJ. A behavioral approach to achieving initial cocaine abstinence. Am J Psychiatry 1991; 148: 1218–24.
25.Hubbard, R, Marsden, M, Rachal, J. Drug abuse treatment: a national study of effectiveness. Chapel Hill, NC: The University of North Carolina Press, 1989.



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