title: A systematic review of the effectiveness of naltrexone in the maintenance treatment of opioid and alcohol dependence.
abstract: This systematic review summarises evidence of the effectiveness of naltrexone (NTX) and the added value of psychosocial treatment in the maintenance treatment of opioid and alcohol dependence. Studies were selected through a literature search conducted in March 2004. Seven opioid and seventeen alcohol studies were identified. When possible, meta-(regression) analyses were performed. There is lack of evidence about the effectiveness of NTX in the maintenance treatment of opioid dependence. There is evidence for the effectiveness and applicability of NTX in the management of alcohol dependence. The opioid studies combined NTX with a variety of psychosocial interventions, which plagued the evaluation of their value. Concomitant psychosocial interventions used in the alcohol studies were mainly cognitive behavioural, which seems to be more effective than NTX combined with supportive therapy. Available data do not allow firm conclusions regarding the added effect of psychosocial interventions. However, the data suggest that a combination of naltrexone with cognitive behavioural relapse prevention therapy is beneficial in alcohol dependent patients.
authors.affiliation: Novadic-Kentron, Network for Addiction Treatment Services, Roosendaal/Sint-Oedenrode, The Netherlands. hendrik.roozen@novadic-kentron.nl
authors.forename: Hendrik G
authors.initials: HG
authors.lastname: Roozen
authors.forename: Ranne
authors.initials: R
authors.lastname: de Waart
authors.forename: Danielle A W M
authors.initials: DA
authors.lastname: van der Windt
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Cor A J
authors.initials: CA
authors.lastname: de Jong
authors.forename: Ad J F M
authors.initials: AJ
authors.lastname: Kerkhof
mesh_terms: D000437:Alcoholism / Q000534:rehabilitation*; D002986:Clinical Trials as Topic; D006801:Humans; D008134:Long-Term Care; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011613:Psychotherapy; D012107:Research Design
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone