Naltrexone Implant for Opioid Use Disorder.

Autor: Edinoff AN; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Nix CA; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Orellana CV; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., StPierre SM; School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Crane EA; School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Bulloch BT; School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Cornett EM; Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA., Kozinn RL; Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, TX 75390, USA., Kaye AM; Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA., Murnane KS; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA.; Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA.; Louisiana Addiction Research Center, Shreveport, LA 71103, USA., Kaye AD; Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA.
Jazyk: angličtina
Zdroj: Neurology international [Neurol Int] 2021 Dec 30; Vol. 14 (1), pp. 49-61. Date of Electronic Publication: 2021 Dec 30.
DOI: 10.3390/neurolint14010004
Abstrakt: The continued rise in the availability of illicit opioids and opioid-related deaths in the United States has left physicians, researchers, and lawmakers desperate for solutions to this ongoing epidemic. The research into therapeutic options for the treatment of opioid use disorder (OUD) began with the introduction of methadone in the 1960s. The approval of oral naltrexone initially showed much promise, as the drug was observed to be highly potent in antagonizing the effects of opioids while producing no opioid agonist effects of its own and having a favorable side effect profile. Patients that routinely take their naltrexone reported fewer days of heroin use and had more negative drug tests than those without treatment. Poor outcomes in OUD patients treated with naltrexone have been directly tied to short treatment time. Studies have shown that naltrexone given orally vs. as an implant at the 6-month interval showed a higher non-compliance rate among those who used oral medications at the 6-month mark and a slower return to use rate. There were concerns that naltrexone could possibly worsen negative symptoms seen in opiate use disorder related to blockade of endogenous opioids that are important for pleasurable stimuli. Studies have shown that naltrexone demonstrated no increase in levels of anxiety, depression and anhedonia in participants and another study found that those treated with naltrexone had a significant reduction in mental health-related hospitalizations. The latter study also concluded that there was no increased risk for mental health-related incidents in patients taking naltrexone via a long-acting implant. Although not yet FDA approved in the United States, naltrexone implant has shown promising results in Europe and Australia and may provide a novel treatment option for opioid addiction.
Databáze: MEDLINE
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