Take The First Step
Dr. Michael Levy
Q: I have been hearing that parents of opioid-addicted children want more information about naltrexone. Do you have any experience with this treatment? Does it work? Thanks.
A: There are two ways that naltrexone-type medication is being used for the treatment of opiate addiction. I say naltrexone-type medication because in general, naltrexone is an oral form of the medication naloxone, and naloxone is also used, which can be injected or inhaled. One use of this drug is to increase abstinence rates and enhance treatment outcome, and the other is to counter an opiate overdose.
First, naltrexone is a pure opiate antagonist, which means that it blocks the effects of opiates because it binds on the same receptor sites that opiates bind to in the brain. If a person has ingested naltrexone and uses opiates, the person will not feel the effect of the opiate.
Naltrexone has been around for many years, and while it is effective, its use has been fairly low for a number of reasons. One big reason for this is that many individuals who struggle with opiates are ambivalent about taking this drug because they clearly will not be able to get high on opiates if they have naltrexone in their system. As often there is ambivalence about changing, compliance with taking this drug has been low.
However, if a person is very motivated, treatment outcome can be very good. As I always say, ongoing psychosocial therapy in conjunction with taking this medication is also important. There are also naltrexone implants that can be used, which increases compliance as the naltrexone in the implant lasts for an extended period of time and there is no need to remember to take it daily. Finally, an injectable form of naltrexone, called Vivitrol, can also be used, which lasts for one month. However, Vivitrol is not FDA-approved for the treatment of opiate addiction, but some physicians have been using this off-label for that purpose.
Narcan, or naloxone, is also used to treat opiate overdoses and saves lives. If a person who has overdosed on opiates is given this drug, it rapidly will counter the effects of opiates and reverse the overdose. This drug is given at emergency rooms and by emergency medical technicians (EMTs).
There are also several pilot programs in Massachusetts that give a nasal form of Narcan to opiate addicts, as well as friends and relatives of opiate addicts. These individuals are trained how to use Narcan in the event that someone has overdosed on opiates. This obviously allows the opiate overdose to be treated quickly, even before EMTs arrive, and helps to save the person's life. CAB is one of the pilot programs and a person can call 781-592-4477 to find out more about this.
So in answer to your question, different forms of naltrexone are being used for the treatment of opiate addiction, both to help individuals recover from opiate addiction, and to treat, on an emergency basis, opiate overdoses. This medication can be helpful to opiate addicts who are motivated to stop using opiates, and on an emergency basis, it can clearly save someone's life.
Great thoughts you got there, believe I may possibly try just some of it throughout my daily life.