Naltrexone maintenance treatment
for opioid dependence

by
Kirchmayer U, Davoli M, Verster A
Osservatorio Epidemiologico della Regione Lazio,
Via di S. Costanza, 53,
Rome, Lazio,
ITALY, 00198.
oss.epid.reg.lazio@agora.stm.it
Cochrane Database Syst Rev 2000; 2:CD001333


ABSTRACT

BACKGROUND: Despite widespread use of naltrexone maintenance in many countries for more than ten years now (e.g., USA since 1984, UK since 1988) a sound documentation of the research on this drug is still missing. OBJECTIVES: To evaluate the effects of naltrexone maintenance treatment in preventing relapse in opioid addicts after detoxification. SEARCH STRATEGY: We searched MEDLINE, EMBASE, CCTR and handsearched the "Bolletino per le Farmacodipendenze e l'Alcolismo"; contact was sought with pharmaceutical producers of naltrexone, with authors and other CRGs; references of obtained studies. Trials were reliably identified and data extracted. Date of most recent searches: June 1998. SELECTION CRITERIA: All studies controlled for naltrexone; treatment of heroin addicts after detoxification with naltrexone. Studies were classified into three categories (high, moderate or low risk of bias) according to their methodological quality. DATA COLLECTION AND ANALYSIS: Reviewers evaluated data independently and analysed outcome measures taking into consideration adherence to and success of the study intervention. Data was extracted and analysed stratifying for the three categories of study quality. Where possible, meta-analysis was performed. MAIN RESULTS: Eleven studies were included in this review, and not all of them were randomised. Meta-analysis could be done to a low degree only, because the studies and their outcomes were very heterogeneous. The result of this quantitative analysis was statistically poor, and so was the methodological quality of the included studies. REVIEWER'S CONCLUSIONS: The available trials do not allow a final evaluation of naltrexone maintenance treatment yet. A trend in favour of treatment with naltrexone was observed for certain target groups, as described in the literature before. A well-done clinical trial is needed in order to get better evidence as soon as possible.
Naloxone
Nociceptin
Oxycodone
Endomorphins
6beta-naltrexol
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Ultra-low-dose naltrexone
Naltrexone for fibromyalgia
Sustained-release naltrexone
Naltrexone-induced dysphoria
Naltrexone plus buprenorphine
Naltrexone (Trexan) : structure
Naltrexone and aerobic exericise
Depot naltrexone, heroin and pleasure
Naltrexone (Trexan) and sexual addicts
Can low-dose naltrexone improve quality of life?
Sustained-release naltrexone for opioid dependence
Naltrexone in microgram doses obviates withdrawal syndrome
Naltrexone for kleptomaniacs: drug reduces compulsion to steal