Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial.

dc.contributor.author

Mannelli, Paolo

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Patkar, Ashwin A

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Peindl, Kathi

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Gorelick, David A

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Wu, Li-Tzy

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Gottheil, Edward

dc.date.accessioned

2023-10-02T19:44:51Z

dc.date.available

2023-10-02T19:44:51Z

dc.date.issued

2009-04

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2023-10-02T19:44:50Z

dc.description.abstract

Although current treatments for opioid detoxification are not always effective, medical detoxification remains a required step before long-term interventions. The use of opioid antagonist medications to improve detoxification has produced inconsistent results. Very low dose naltrexone (VLNTX) was recently found to reduce opioid tolerance and dependence in animal and clinical studies. We decided to evaluate safety and efficacy of VLNTX adjunct to methadone in reducing withdrawal during detoxification. In a multi-center, double-blind, randomized study at community treatment programs, where most detoxifications are performed, 174 opioid-dependent subjects received NTX 0.125 mg, 0.250 mg or placebo daily for 6 days, together with methadone in tapering doses. VLNTX-treated individuals reported attenuated withdrawal symptoms [F = 7.24 (2,170); P = 0.001] and reduced craving [F = 3.73 (2,107); P = 0.03]. Treatment effects were more pronounced at discharge and were not accompanied by a significantly higher retention rate. There were no group differences in use of adjuvant medications and no treatment-related adverse events. Further studies should explore the use of VLNTX, combined with full and partial opioid agonist medications, in detoxification and long-term treatment of opioid dependence.

dc.identifier

ADB119

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1355-6215

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1369-1600

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https://hdl.handle.net/10161/29083

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Addiction biology

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10.1111/j.1369-1600.2008.00119.x

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Humans

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Opioid-Related Disorders

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Substance Withdrawal Syndrome

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Methadone

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Naltrexone

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Analgesics, Opioid

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Narcotic Antagonists

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Drug Administration Schedule

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Double-Blind Method

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Community Mental Health Services

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Adult

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Program Development

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Female

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Male

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Inactivation, Metabolic

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Disruptive, Impulse Control, and Conduct Disorders

dc.title

Very low dose naltrexone addition in opioid detoxification: a randomized, controlled trial.

dc.type

Journal article

duke.contributor.orcid

Mannelli, Paolo|0000-0002-7834-6138

duke.contributor.orcid

Wu, Li-Tzy|0000-0002-5909-2259

pubs.begin-page

204

pubs.end-page

213

pubs.issue

2

pubs.organisational-group

Duke

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Sanford School of Public Policy

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School of Medicine

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Faculty

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Clinical Science Departments

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Institute for Brain Sciences

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Psychiatry, Child & Family Mental Health & Community Psychiatry

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Center for Child and Family Policy

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Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychology

pubs.publication-status

Published

pubs.volume

14

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