Effectiveness and Compliance of Naltrexone in Opioid-dependent Patients: A Pilot Study From India

ObjectivesThe study examined the effectiveness and compliance of naltrexone in opioid-dependent patients and also assessed the drug use pattern of the patients. MethodsThirty-five patients satisfying the DSM-IV criteria for opioid dependence were included in the study. Information regarding socio-demographic profile and drug use pattern of the patients was collected followed by urine testing for opioids, naltrexone, and cannabis. ResultsThe primary drug of use among the patients was found to be heroin. The duration of naltrexone use varied from 1 week to 12 months across the study sample and the mean duration of use was found to be 3.4 months. While on naltrexone, substance abuse (excluding opiates) was present in 37.4% patients. Among these patients, 26% were taking alcohol and 11.4% of the patients were consuming cannabis while on medication. The urine sample of all the subjects tested positive for naltrexone indicating good compliance on the medication. DiscussionDespite the small sample size and nonhomogeneity in terms of period of being on naltrexone therapy, the study highlights 2 issues. Firstly, naltrexone seems to help patients in staying abstinent from opioid drugs and secondly a significant proportion of patients is likely to indulge in drug substitution like alcohol and/or cannabis. The latter observation raises concerns regarding the efficacy of naltrexone in managing alcohol dependence. The neurochemical basis for the finding needs to be explored in detail and the physician should be cautious about any change of drug use pattern in-patients on treatment with naltrexone.