AIM: To evaluate the efficacy of naltrexone maintenance treatment in preventing relapse in opioid addicts after detoxification. DESIGN: A systematic review according to the methodology developed by the Cochrane Collaboration based on either randomized controlled trials (RCTs) or controlled clinical trials (CCTs). PARTICIPANTS: Seven hundred and seven heroin dependent in- and out-patients, or former heroin addicts dependent on methadone and participating in a naltrexone treatment programme; 89% were male. INTERVENTION: Maintenance treatments on opiate dependent people after detoxification, comparing naltrexone with placebo, pharmacological or behavioural treatments. MEASUREMENTS: The outcomes considered were successfully completed treatment, opioid use under treatment (re)-incarcerations during the study period, mean duration of treatment. FINDINGS: The outcomes tended to be slightly although not significantly in favour of the naltrexone groups. Use of naltrexone in addition to behavioural treatment significantly decreased the probability of (re-)incarceration (OR=0.30; 95% CI 0.12, 0.76). The difficulties in producing a quantitative analysis were due mainly to the heterogeneity of the included studies. CONCLUSIONS: From the available clinical trials performed up to this time, there is insufficient evidence to justify the use of naltrexone in maintenance treatment of opioid addicts.
AIM: To evaluate the efficacy of naltrexone maintenance treatment in preventing relapse in opioid addicts after detoxification. DESIGN: A systematic review according to the methodology developed by the Cochrane Collaboration based on either randomized controlled trials (RCTs) or controlled clinical trials (CCTs). PARTICIPANTS: Seven hundred and seven heroin dependent in- and out-patients, or former heroin addicts dependent on methadone and participating in a naltrexone treatment programme; 89% were male. INTERVENTION: Maintenance treatments on opiate dependent people after detoxification, comparing naltrexone with placebo, pharmacological or behavioural treatments. MEASUREMENTS: The outcomes considered were successfully completed treatment, opioid use under treatment (re)-incarcerations during the study period, mean duration of treatment. FINDINGS: The outcomes tended to be slightly although not significantly in favour of the naltrexone groups. Use of naltrexone in addition to behavioural treatment significantly decreased the probability of (re-)incarceration (OR=0.30; 95% CI 0.12, 0.76). The difficulties in producing a quantitative analysis were due mainly to the heterogeneity of the included studies. CONCLUSIONS: From the available clinical trials performed up to this time, there is insufficient evidence to justify the use of naltrexone in maintenance treatment of opioid addicts.
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-03-09 Impact factor: 8.262
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-10-13 Impact factor: 8.262
Authors: Kelly E Dunn; Anthony Defulio; Jeffrey J Everly; Wendy D Donlin; Will M Aklin; Paul A Nuzzo; Jeannie-Marie S Leoutsakos; Annie Umbricht; Michael Fingerhood; George E Bigelow; Kenneth Silverman Journal: Exp Clin Psychopharmacol Date: 2012-12-03 Impact factor: 3.157