Early outcomes following low dose naltrexone enhancement of opioid detoxification

Abstract

Although withdrawal severity and treatment completion are the initial focus of opioid detoxification, post-detoxification outcome better defines effective interventions. Very low dose naltrexone (VLNTX) in addition to methadone taper was recently associated with attenuated withdrawal intensity during detoxification. We describe the results of a seven-day follow-up evaluation of 96 subjects who completed inpatient detoxification consisting of the addition of VLNTX (0.125 or 0.250 mg per day) or placebo to methadone taper in a double blind, randomized investigation. Individuals receiving VLNTX during detoxification reported reduced withdrawal and drug use during the first 24 hours after discharge. VLNTX addition was also associated with higher rates of negative drug tests for opioids and cannabis and increased engagement in outpatient treatment after one week. Further studies are needed to test the utility of this approach in easing the transition from detoxification to various follow-up treatment modalities designed to address opioid dependence.

Trial registration: ClinicalTrials.gov NCT00135759.

Figures

FIGURE 1

Subjective opioid withdrawal scores (SOWS) in 96 opioid-dependent subjects. On the day following detoxification (day seven), VLNTX-treated individuals reported significantly reduced withdrawal (ANCOVA, controlling for score on day six, F = 174.7 (2,94); p = 0.001). The shadowed area indicates inpatient detoxification.

FIGURE 2

Objective opioid withdrawal scores (OOWS) in 96 opioid-dependent subjects. On the day following detoxification (day seven), VLNTX-treated individuals showed significantly reduced withdrawal (ANCOVA, controlling for scores on day six, F = 169.5 (2,96); p = 0.001). The shadowed area indicates inpatient detoxification.