title: Injectable and implantable sustained release naltrexone in the treatment of opioid addiction.
abstract: Sustained release technologies for administering the opioid antagonist naltrexone (SRX) have the potential to assist opioid-addicted patients in their efforts to maintain abstinence from heroin and other opioid agonists. Recently, reliable SRX formulations in intramuscular or implantable polymers that release naltrexone for 1-7 months have become available for clinical use and research. This qualitative review of the literature provides an overview of the technologies currently available for SRX and their effectiveness in reducing opioid use and other relevant outcomes. The majority of studies indicate that SRX is effective in reducing heroin use, and the most frequently studied SRX formulations have acceptable adverse events profiles. Registry data indicate a protective effect of SRX on mortality and morbidity. In some studies, SRX also seems to affect other outcomes, such as concomitant substance use, vocational training attendance, needle use, and risk behaviour for blood-borne diseases such as hepatitis or human immunodeficiency virus. There is a general need for more controlled studies, in particular to compare SRX with agonist maintenance treatment, to study combinations of SRX with behavioural interventions, and to study at-risk groups such as prison inmates or opioid-addicted pregnant patients. The literature suggests that sustained release naltrexone is a feasible, safe and effective option for assisting abstinence efforts in opioid addiction.
authors.affiliation: The Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway; Oslo University Hospital, Oslo, Norway.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Kunøe
authors.forename: Philipp
authors.initials: P
authors.lastname: Lobmaier
authors.forename: Hanh
authors.initials: H
authors.lastname: Ngo
authors.forename: Gary
authors.initials: G
authors.lastname: Hulse
mesh_terms: D003692:Delayed-Action Preparations; D004343:Drug Implants; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000534:rehabilitation; D006801:Humans; D009271:Naltrexone / Q000008:administration & dosage* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000534:rehabilitation; D011329:Prisoners; D013997:Time Factors
chemical_list: D003692:Delayed-Action Preparations; D004343:Drug Implants; D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: drug addiction; drug dependence; naltrexone; opioids; substance-related disorders; sustained release