Naltrexone Implants Compared to Methadone: Outcomes Six Months after Prison Release

Lobmaier, Philipp; Kunøe, Nikolaj; Gossop, Michael; Katevoll, Tormod; Waal, Helge

doi:10.1159/000313336

Cited by 74 publications

(52 citation statements)

References 110 publications

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“…Slow release depot or implant formulations might secure protective levels of antagonist for extended periods [8][9]. No neuroadaptation occurs [10], and the baby would be born without NAS and without intrauterine opioid exposure.…”

mentioning

confidence: 99%

Is sustained release natrexone an option for heroin‐dependent pregnant women?

Waal

2013

Addiction

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mentioning

confidence: 99%

Is sustained release natrexone an option for heroin‐dependent pregnant women?

Waal

2013

Addiction

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“…The two prisons participated in this study as part of a wider clinical research project (Lobmaier et al, 2010). Prison staff were accustomed to routinely distributing survey questionnaires before the nightly lock up and collecting them the following day.…”

Section: Methodsmentioning

confidence: 99%

Substance use and problem awareness among drug-involved prisoners in Norway

Lobmaier

Berman

Gossop

et al. 2012

Journal of Substance Use

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A sample of 110 drug-involved offenders from two prisons was assessed regarding drug and alcohol consumption, problem awareness, ambivalence and treatment readiness. Of these, 56% reported hazardous alcohol consumption and 53% highly problematic drug use. Highly problematic users reported more problem awareness and more cognitive dissonance regarding change. Treatment readiness was rated higher by problematic users as compared to users reporting fewer problems. The influence of prison environment on ambivalence needs to be studied longitudinally after imprisonment. Identification of drug-involved prisoners should be done systematically, including assessment of alcohol consumption. Opportunities for substance misuse treatment in prisons should be increased.

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“…Lobmaier et al 11 studied imprisoned heroin-related offenders, who are at especially high risk of relapse (and fatal overdose) after release. They compared the effects of GMI or methadone maintenance treatment (MMT) on the use of heroin (and other illicit drugs) and criminality among heroindependent inmates after they left prison.…”

Section: Clinical Trials Of Ntx Implants and Dismentioning

confidence: 99%

Últimos desarrollos en los implantes y las inyecciones depot de naltrexona; el jovencito de la escalera se está haciendo mayor

Brewer¹,

Streel²

2010

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Implants and depot injections (DI) of naltrexone (NTX) have undergone considerable development since the first commercially available implants appeared in the mid-1990s. In particular, long-acting implants that can deliver relapse-preventing serum NTX levels for around six months have now been subjected to classic randomised controlled trials that have given positive and generally significant results when compared with oral NTX and placebo implants, or with standard post-detoxification care. They also provide lower serum levels that can prevent opiate overdose for several additional months and 3-year mortality rates are similar to those of methadone maintenance treatment (MMT). At least 18 months of antagonist-assisted abstinence may be desirable to normalise new, opiatefree cognitive-behavioural habits and extinguish old, maladaptive ones. We discuss ideological antagonisms between protagonists of MMT and of NTX implants, notably in Australia, but we argue that both treatments can and should co-exist. The main obstacle to the expansion of longacting implant treatment is not the lack of an evidential or theoretical base but the lack of a licensed product. NTX appears to block all opiates if serum levels are adequate and we stress its apparent lack of clinically significant hepatotoxicity. Some patients may need above-average serum levels and occasionally, habitual injectors continue to inject opiates despite experiencing no opiate effects. RESUMEN ABSTRACTLos implantes y las inyecciones depot (ID) de naltrexona (NTX) han experimentado un notable desarrollo desde que aparecieron los primeros implantes comerciales a mediados de los noventa. Específicamente los implantes de larga duración, capaces de proporcionar NTX en suero con niveles capaces de prevenir las recaídas durante unos 6 meses, han sido sometidos recientemente a las clásicas pruebas con control, con resultados positivos y, generalmente, significativamente superiores a la NTX oral o implantes de placebo o tratamientos estándar post desintoxicación. Además proporcionan niveles en sangre suficientes durante varios meses más para prevenir sobredosis por opiáceos. Por otro lado los índices de mortalidad a tres años son similares a los que están en programas de mantenimiento con metadona (PMM). Por lo menos serán necesarios 18 meses de abstinencia con el apoyo de antagonistas para normalizar los nuevos hábitos de comportamiento sin opiáceos y extinguir los viejos hábitos perjudiciales. Se discuten los antagonismos ideológicos que se dan, sobre todo en Australia, entre los protagonistas de PMM y los de implantes de NTX, concluyendo que ambos tipos pueden y deben coexistir. El principal obstáculo para la expansión de los tratamientos con implantes de larga duración no sería pues la falta de evidencia o de base teórica, sino la inexistencia de un fármaco con licencia. NTX parece que bloquea todos los opiáceos si sus niveles en suero son los adecuados; por otro lado debemos tener en cuenta su aparente falta de hepatotoxicidad. Algunos pacientes pueden necesita...

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Naltrexone Implants Compared to Methadone: Outcomes Six Months after Prison Release

Cited by 74 publications

References 110 publications

Is sustained release natrexone an option for heroin‐dependent pregnant women?

Is sustained release natrexone an option for heroin‐dependent pregnant women?

Substance use and problem awareness among drug-involved prisoners in Norway

Últimos desarrollos en los implantes y las inyecciones depot de naltrexona; el jovencito de la escalera se está haciendo mayor

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