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Review
Injectable and implantable sustained release naltrexone in the treatment of opioid addiction
DOI: 10.1111/bcp.12011
© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society
Issue
British Journal of Clinical Pharmacology
Additional Information
Publication History
- Accepted manuscript online: 22 OCT 2012 10:51PM EST
- Manuscript Accepted: 16 OCT 2012
- Abstract
- Cited By
Keywords:
- opioids;
- drug dependence;
- drug addiction;
- substance-related disorders;
- naltrexone;
- sustained release
Summary
Background
Sustained release technologies for administering the opioid antagonist naltrexone (SRX) have the potential to assist opioid-addicted patients in their efforts to maintain abstinence from heroin and other opioid agonists. Recently, reliable SRX formulations in intramuscular or implantable polymers that release naltrexone for 1-7 months have become available for clinical use and - research.
Methods
This qualitative review of the literature provides an overview of the technologies currently available for sustained release naltrexone (SRX) and their effectiveness in reducing opioid use and other relevant outcomes.
Results
The majority of studies indicate that SRX is effective in reducing heroin use, and the most frequently studied SRX formulations have acceptable adverse events profiles. Registry data indicate a protective effect of SRX on mortality and morbidity. In some studies, SRX also seems to affect other outcomes like concomitant substance use, vocational training attendance, needle use, and risk behaviour for blood-borne diseases like Hepatitis or HIV. There is a general need for more controlled studies, in particular comparing SRX with agonist maintenance treatment, combinations of SRX with behavioural interventions, and with at-risk groups like prison inmates or opioid addicted pregnant patients.
Conclusion
The literature suggests that sustained release naltrexone is a feasible, safe and effective option for assisting abstinence efforts in opioid addiction.