title: Behavioral naltrexone therapy: an integrated treatment for opiate dependence.
abstract: 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.
authors.affiliation: 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
authors.forename: Jami L
authors.initials: JL
authors.lastname: Rothenberg
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sullivan
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Church
authors.forename: Angela
authors.initials: A
authors.lastname: Seracini
authors.forename: Eric
authors.initials: E
authors.lastname: Collins
authors.forename: Herbert D
authors.initials: HD
authors.lastname: Kleber
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: 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
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D009271:Naltrexone; D008691:Methadone