Sustained release naltrexone for opioid dependence: : Effectiveness, safety, and clinical feasibility
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AbstractThe current standard for clinical treatment of dependence on heroin and other opioids is to maintain the dependence with slower-acting opioids like methadone or buprenorphine. Breaking patients’ physical dependence on opioids is considered dangerous due to detoxified users’ high risk of relapse and overdose. Recently, a new treatment for opioid dependence has become available for research in humans: sustained release formulations of the opioid-blocking medication naltrexone (SRX). How effective, safe, and practically feasible SRX is in clinical settings is not yet clear. The research project presented herein consisted of a systematic review of the knowledge on SRX treatment, a randomized controlled trial of SRX in an ordinary clinical setting, a study of heroin use among SRX patients, and an investigation of dropout/retention in patients treated with implantable SRX. In addition, this thesis contains a general introduction and an evaluation of the contribution of the above project to clinical SRX research.
List of papers
|Paper 1: Lobmaier P., Kornør H., Kunøe N., Bjørndal A., 2008. Sustained release naltrexone for opioid dependence (review). The Cochrane Database of Systematic Reviews 2008, Issue 2, Art. No. CD006140. The published version of this paper is available at: https://doi.org/10.1002/14651858.CD006140.pub2|
|Paper 2: Kunøe N., Lobmaier P., Vederhus J.K., Hjerkinn B., Hegstad S., Gossop M., Kristensen Ø., Waal H., 2009. Naltrexone implants after inpatient treatment for opioid dependence: a randomised controlled trial. The British Journal of Psychiatry. 194, 541-546. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1192/bjp.bp.108.055319|
|Paper 3: Kunøe N., Lobmaier P., Vederhus J.K., Hjerkinn B., Gossop M., Hegstad S., Kristensen Ø., Waal H., in press. Challenges to antagonist blockade during sustained release naltrexone treatment. Addiction (accepted draft). (Published in Addiction (9) 2010. 105, 1633-39. The published version of this paper is available at: https://doi.org/10.1111/j.1360-0443.2010.03031.x|
|Paper 4: Kunøe N., Lobmaier P., Vederhus J.K., Hjerkinn B., Hegstad, S., Gossop M., Kristensen Ø., Waal H., submitted. Retention in naltrexone implant treatment for opioid dependence (draft accepted for review). (Published in Drug & Alcohol Dependence 2010. 111: 166-69. The published version of this paper is available at: https://doi.org/10.1016/j.drugalcdep.2010.03.021|