The 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 2 is removed from the thesis due to copyright restrictions.
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. DOI: 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.
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;
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;