14 May Naltrexone Implants for Heroin Addiction
Naltrexone is an anti-opioid medication that blocks the psychoactive effects of heroin and other legal and illegal opioid narcotic substances. Some doctors use this medication as part of a larger approach for addressing relapse risks in recovering opioid addicts. Current evidence indicates that use of naltrexone may also be beneficial to people with active heroin addictions who want to stop using the drug without the help of opioid-containing treatments such as Subutex or methadone. Because of its relatively low-maintenance requirements for treatment compliance, a long-lasting naltrexone implant typically produces better overall results than oral forms of naltrexone.
Heroin presents a high risk for addiction because it sharply increases the brain’s supply of dopamine, a neurotransmitting chemical produced inside nerve cells (neurons) located in certain regions of the brain. One particular area of the brain where dopamine plays a critical role is the limbic system, a network of neurons that acts as the center for the conscious experience of pleasure and reward. When dopamine levels rise to an unusually high degree (under the influence of heroin or a variety of other drugs), their effects on the limbic system produce an intense form of pleasure called euphoria; heroin and other opioid drugs also produce a strong pain-relieving effect that disrupts the normal pain pathways between the body and the brain. Like other opioids, heroin produces its effects on the brain’s dopamine supply through its ability to interact with specialized sites called opioid receptors, which appear on the surfaces of certain neurons.
In terms of brain chemistry and drug treatment, naltrexone belongs to a group of substances called opioid receptor antagonists. When molecules of this medication enter the brain, they occupy the opioid receptors targeted by heroin and other narcotic drugs and medications. In doing so, naltrexone molecules deny access to the molecules of opioid narcotics and effectively prevent them from producing the dopamine increases associated with the development of an opioid addiction. In the current standard model of naltrexone treatment, doctors only use the medication in recovering addicts who have gone through opioid withdrawal and remained abstinent for an additional week to 10 days, the Substance Abuse and Mental Health Services Administration explains. The rationale for this approach is a desire to avoid unintentionally triggering severe forms of opioid withdrawal that can reduce recovering addicts’ willingness to stay in treatment.
Use in Active Addiction
According to a report released in 2011 by the University of Oslo’s Norwegian Centre for Addiction Research, naltrexone can also play a role in the treatment of people with current heroin addictions when used in the form of timed-release pellets implanted under the skin. At the start of their research, the authors of the report implanted a six-month’s supply of a naltrexone/saline solution combination into the bodies of a group of actively addicted heroin users. Half a year later, they compared the drug usage patterns of these addicts to the usage patterns of a group of addicts who wanted to stop using heroin but did not undergo naltrexone implantation.
The results of this comparison showed that the addicts with naltrexone implants completely abstained from the use of heroin or other opioid drugs more than twice as often as the addicts who did not receive naltrexone. In addition, those addicts with naltrexone implants who did not abstain entirely from heroin use still reduced their overall heroin intake by an average of more than 50 percent. Conversely, a clear majority of all of the addicts who did not receive naltrexone returned to their previous level of heroin intake before the six-month period of the study came to a close.
A separate study, published in 2009 in the Archives of General Psychiatry, compared the treatment effectiveness of naltrexone implants in active heroin addicts to the treatment effectiveness of oral doses of the medication. The authors of the study concluded that addicts using oral naltrexone have a significant tendency to skip doses of the medication, and therefore often don’t have enough naltrexone in their systems to successfully combat heroin’s ability to access the brain’s opioid receptors. On the other hand, because they have no medication doses to take after the initial implantation process, people using naltrexone implants have no option to skip their treatment, and therefore typically have therapeutically beneficial levels of the medication in their systems.
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