Naltrexone Implant Aids Heroin Addiction Treatment in Russia

Naltrexone, the medicine used to treat opioid addiction, has been used in Russia and in some treatment centers in the United States for some time now. It is an opioid receptor antagonist that blocks opioids from binding to the opioid receptor that produces their pleasurable effects. In order for naltrexone therapy to successfully ward off relapse, patients must take consistent doses even though the drug does not do much to suppress drug cravings. 

A six-month clinical trial conducted in St. Petersburg, Russia, concluded that an implanted delivery device was more effective than the pill in naltrexone treatment for heroin addicts (NIDA, 2013). The implanted device released a continuous, steady dose of naltrexone for two months, and was three times more effective than the oral dose in preventing relapse. The oral dose of the drug “yielded a slightly, but statistically nonsignificant, higher rate of remission from heroin use than placebo,” according to the National Institute on Drug Abuse (2013). Within the six months of the clinical trial, 80 percent of the participants taking the oral dose relapsed. 

The study involved 306 heroin-addicted volunteers. Each volunteer underwent detoxification and was assigned to one of three groups. The first group contained the oral naltrexone and a placebo, the second group contained the implanted naltrexone device and a placebo, and the third group contained only placebos. In addition, each group received biweekly counseling.  At the end of six months, 53 percent of participants who received the naltrexone implant had not relapsed, as well as 16 percent who received the oral naltrexone, and 11 percent in the placebo group (NIDA, 2013). 

Negative effects of the implant, as observed in the study, included irritation and infection at the injection site and an unexplained 10 percent of participants with the implant who did relapse. Dr. George Woody, one of the study’s coleaders, stated that the unexplained 10 percent “could be due to the fibrosis around the implant that caused the medication to get locked in, so that it couldn’t reach the appropriate blood levels, or perhaps the medication was released too quickly and depleted too early” (NIDA, 2013). The infections were treated and resolved with antibiotics or allergy medications. 

Furthermore, the study noticed that six months after the trial had been completed, almost all participants had relapsed. This led the researchers to the conclusion that a six-month implanted naltrexone treatment was too short. 

The results of this study were published in the Archives of General Psychiatry and Addiction journals. 

References

National Institute on Drug Abuse (NIDA). (2013). Naltrexone implant outperforms daily pill in Russian trail. NIDA Notes. Retrieved from http://www.drugabuse.gov/news-events/nida-notes/2013/11/naltrexone-implant-outperforms-daily-pill-in-russian-trial?utm_source=Updates&utm_medium=MailChimp&utm_content=12.17.2013&utm_campaign=NIDANotes