Cristin-resultat-ID: 501295
Sist endret: 12. august 2013 13:34
Resultat
Vitenskapelig oversiktsartikkel/review
2008

Sustained-release naltrexone for opioid dependence

Bidragsytere:
  • Philipp Paul Lobmaier
  • Hege Kornør
  • Nikolaj Kunøe og
  • Arild Bjørndal

Tidsskrift

Cochrane Database of Systematic Reviews
ISSN 1469-493X
e-ISSN 1469-493X
NVI-nivå 1

Om resultatet

Vitenskapelig oversiktsartikkel/review
Publiseringsår: 2008
Hefte: 2

Importkilder

Isi-ID: 000255119900038

Beskrivelse Beskrivelse

Tittel

Sustained-release naltrexone for opioid dependence

Sammendrag

People with opioid dependence require substantial therapeutic effort to keep them drug free. Their use of illicit opioids can be reduced and retention in treatment improved with supervised agonist replacement therapy with methadone, which is a highly addictive drug. Naltrexone is a long-acting, opioid-antagonist that blocks heroin effects. It is used to prevent relapse of both opioid and alcohol dependence. Highly motivated people do best with naltrexone. Most opioid users are sceptical about treatment with naltrexone tablets and many drop out early on. Dropouts can be reduced with supervised tablet taking, offering incentives and using sustained-release naltrexone such as subcutaneous implants or depot injections. There is insufficient evidence from randomised controlled trials to evaluate the effectiveness of sustained-release naltrexone. In the one controlled study that met inclusion criteria, 60 outpatients were randomised to one of three groups that received two sequential depot injections of naltrexone (192 or 384 mg) or placebo injections. The mean dropout time was 48 days with high dose naltrexone compared with 27 days on placebo; an increase in treatment of 21 days (range 11 to 31 days). The lower depot dose gave a lesser benefit. The number retained in treatment at eight weeks did not show a clear difference and ranged from a mean of 68% to 39% of participants in the different groups. 'Wanting heroin' did not differ on naltrexone but 'needing heroin' scored significantly lower with depot naltrexone compared to placebo. The most prominent adverse effects were general symptoms of fatigue and pain at the injection site. Seventeen reports met inclusion criteria for assessing adverse effects. Seven looked specifically at naltrexone implants for treatment of opioid dependence and wound infection, allergic reaction to the implant and number of implants removed. The majority of the trials did not have a control group and systematic assessment of adverse effects was lacking.

Bidragsytere

Aktiv cristin-person

Philipp Paul Lobmaier

  • Tilknyttet:
    Forfatter
    ved SERAF- Senter for rus og avhengighetsforskning ved Universitetet i Oslo
Aktiv cristin-person

Hege Kornør

  • Tilknyttet:
    Forfatter
    ved Folkehelseinstituttet
Aktiv cristin-person

Nikolaj Kunøe

  • Tilknyttet:
    Forfatter
    ved Senter for rus- og avhengighetsforskning ved Universitetet i Oslo
Aktiv cristin-person

Arild Bjørndal

  • Tilknyttet:
    Forfatter
    ved Seksjon for allmennmedisin ved Universitetet i Oslo
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