title: Does naltrexone affect craving in abstinent opioid-dependent patients?
abstract: Naltrexone blocks the opioid receptors that modulate the release of dopamine in the brain reward system and therefore blocks the rewarding effects of heroin and alcohol. It is generally assumed that naltrexone leads to reduction of craving, but few studies have been performed to prove this. The purpose of the present study was to examine the effect of the administration of naltrexone on craving level after rapid opioid detoxification induced by naltrexone. A naturalistic study was carried out in which patients were followed during 10 months after rapid detoxification. Data about abstinence, relapse, and naltrexone use were collected by means of urine specimens. Craving was measured by the visual analogue scale craving, the Obsessive Compulsive Drug Use Scale, and the Desires for Drug Questionnaire. Results showed that patients who relapsed in opioid use experienced obviously more craving than abstinent people. Patients who took naltrexone did not experience significant less craving than those who did not. These results suggest that the use of opioids is associated with increased craving and that abstinence for opioids is associated with less craving, independent of the use of naltrexone. This is in contrast to the general opinion. Because of the naturalistic design of the study, no firm conclusions can be drawn, but the results grounded the needs of an experimental study.
authors.affiliation: Novadic-Kentron, Network for Addiction Treatment Services, Sint-Oedenrode, The Netherlands. boukje.dijkstra@novadic-kentron.nl
authors.forename: Boukje A G
authors.initials: BA
authors.lastname: Dijkstra
authors.forename: Cor A J
authors.initials: CA
authors.lastname: De Jong
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Bluschke
authors.forename: Paul F M
authors.initials: PF
authors.lastname: Krabbe
authors.forename: Cees P F
authors.initials: CP
authors.lastname: van der Staak
mesh_terms: D000328:Adult; D005260:Female; D003932:Heroin / Q000009:adverse effects; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000009:adverse effects; D008875:Middle Aged; D009042:Motivation; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D055502:Secondary Prevention; D015813:Substance Abuse Detection; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone; D003932:Heroin; D008691:Methadone