Naltrexone

Naltrexone is a drug that blocks the effects of heroin, methadone and other opiates, such as morphine, Codeine, and reduces the ‘highs’ associated with alcohol consumption. It can, therefore, help patients remain abstinent in opiate and alcohol dependence. Naltrexone is not a new drug. It was synthesised in the 1960s and first used clinically in the early 1970s.

Naltrexone enters the brain and nervous system and attaches itself to small areas called receptor sites. For heroin to produce effects, it must get these same receptor sites, but Naltrexone stops heroin getting to them for up to three days after an oral dose. These receptors are part of the complex reward mechanism that motivates us and leads to repetitive behaviour. If the reward is blocked the craving and dependence behaviour reduces and new behaviours reassert themselves with time. It works well for opiate addiction and often, but less predictably, in alcohol dependence.

Naltrexone helps prevent relapse. Most heroin addicts have at least one relapse after getting clean. Research indicates that addicts who take Naltrexone regularly have a better chance of staying clean than with other treatment, Naltrexone is, therefore, indicated for any opiate addict who wants to stop using opiates but who has never managed for long, or at all, or who thinks that relying on will-power, NA or counselling alone will not work for them. It might also be indicated problem drinkers hoping to reduce relapses, for who it has a clear benefit,

Definitely not. Even after several months, there are no withdrawal symptoms if you stop suddenly.

Implants have been found to be effective by removing the risk of non-compliance. Patients are much less likely to use heroin or other opiates during the period of treatment with implants.

It is extremely effective. Most addicts try using heroin soon after starting Naltrexone. Once they realise that smoking or injecting heroin does not affect, they don’t usually waste their money by trying again.

Naltrexone has very few side effects and only very rarely are serious. A few patients experience slight tiredness and indigestion, or a temporary increase in anxiety or lowering blood of mood. Naltrexone is not recommended for people who have;

• Kidney disease or
• Liver disease (including cirrhosis, hepatitis B or C)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

If you take Naltrexone while you are physically addicted to heroin or other opiates, it will cause withdrawal symptoms within a few minutes. If you stop taking naltrexone and start using heroin in, you are likely to kill yourself if you take your usual dose of heroin right away. People always wonder if it will stop them enjoying life if their reward mechanisms are blocked but interestingly in everyday circumstances it seems to have little or no impact on this. Instead, people are usually very happy and pleased to be opiate or alcohol-free and protected from relapse.

Another study published in The Lancet compared naltrexone to buprenorphine and results showed that while naltrexone is just as effective as buprenorphine once the patient has started taking it, it cannot be started until after detoxification had been completed. This is because naltrexone only works once all opioids had been eliminated from the system during a programme of detox. The conclusion was that while both drugs were effective once treatment had begun, buprenorphine had the advantage in that it can be administered before a full detox had been completed.

We advise all addicts to attend a residential rehab programme to provide the addiction treatment often required in helping a patient to abstain.