title: Early outcomes following low dose naltrexone enhancement of opioid detoxification.
abstract: Although withdrawal severity and treatment completion are the initial focus of opioid detoxification, post-detoxification outcome better defines effective interventions. Very low dose naltrexone (VLNTX) in addition to methadone taper was recently associated with attenuated withdrawal intensity during detoxification. We describe the results of a seven-day follow-up evaluation of 96 subjects who completed inpatient detoxification consisting of the addition of VLNTX (0.125 or 0.250 mg per day) or placebo to methadone taper in a double blind, randomized investigation. Individuals receiving VLNTX during detoxification reported reduced withdrawal and drug use during the first 24 hours after discharge. VLNTX addition was also associated with higher rates of negative drug tests for opioids and cannabis and increased engagement in outpatient treatment after one week. Further studies are needed to test the utility of this approach in easing the transition from detoxification to various follow-up treatment modalities designed to address opioid dependence.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27705, USA. paolo.mannelli@duke.edu
authors.forename: Paolo
authors.initials: P
authors.lastname: Mannelli
authors.forename: Ashwin A
authors.initials: AA
authors.lastname: Patkar
authors.forename: Kathleen
authors.initials: K
authors.lastname: Peindl
authors.forename: Edward
authors.initials: E
authors.lastname: Gottheil
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.forename: David A
authors.initials: DA
authors.lastname: Gorelick
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use; D009271:Naltrexone / Q000008:administration & dosage* / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010919:Placebos; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D010919:Placebos; D009271:Naltrexone; D008691:Methadone