Behavioral naltrexone therapy: an integrated treatment for opiate dependence.
Treatment of opiate dependence with naltrexone has been limited by poor compliance. Behavioral Naltrexone Therapy (BNT) was developed to promote adherence to naltrexone and lifestyle changes supportive of abstinence, by incorporating components from empirically validated treatments, including Network Therapy with a significant other to monitor medication compliance, the Community Reinforcement Approach, and voucher incentives. An overview is presented of the BNT treatment manual. In an uncontrolled Stage I trial (N = 47), 19% completed the 6-month course of treatment. Retention was especially poor in the subsample of patients who were using methadone at baseline (N = 18; 39% completed 1 month, none completed 6 months), and more encouraging among heroin-dependent patients (N = 29; 65% completed 1 month, 31% completed 6 months). Thus, attrition continues to be a serious problem for naltrexone maintenance, although further efforts to develop interventions such as BNT are warranted.
Rothenberg
Jami L
JL
The New York State Psychiatric Institute, Division on Substance Abuse, Substance Treatment and Research Service, 1051 Riverside Drive, New York, NY 10032, USA. rothenb@pi.cpmc.columbia.edu
Sullivan
Maria A
MA
Church
Sarah H
SH
Seracini
Angela
A
Collins
Eric
E
Kleber
Herbert D
HD
Nunes
Edward V
EV
D000328:Adult; D001521:Behavior Therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010349:Patient Compliance; D013997:Time Factors; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D009294:Narcotics; D009271:Naltrexone; D008691:Methadone