Am J Addict. 2009 Mar-Apr;18(2):109-16.
.Department
of Psychiatry & Behavioral Sciences, Duke University Medical
Center, Durham, North Carolina 27705, USA.
paolo.mannelli@duke.edu
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