Opioid overdose deaths can occur in patients with naltrexone implants

Over the past two decades, the NHS has seen wave after wave of destabilising change. British doctors have had to confront an internal market system (in 1991); general practice fund-holding (1992); abolition of regional health authorities and the creation of nine health offices (1996); abolition of fund-holding (1996); a target plan for improving care and cutting waiting times (2000); the introduction of hospital league tables (2001); primary care trusts taking on the planning and commissioning of health care (2002); a hundred-odd health authorities replaced by 28 strategic health bodies (2002); the introduction of foundation trusts (2004); payment by health results (2005); primary care trusts cut from 302 to 152 and strategic health authorities from 28 to 10 (2006); and the abolition of hospital league tables (2006).

[1]  Moira Sim.  Opioid overdose deaths can occur in patients with naltrexone implants , 2007, The Medical journal of Australia.

[2]  L. Degenhardt,et al.  Mortality related to pharmacotherapies for opioid dependence: a comparative analysis of coronial records. , 2007, Drug and alcohol review.

[3]  C. O'brien,et al.  Naltrexone for probationers and parolees. , 2006, Journal of substance abuse treatment.

[4]  R. Mattick,et al.  Serious adverse events in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD). , 2004, Addiction.

[5]  C. Brewer,et al.  Naltrexone implants can completely prevent early (1‐month) relapse after opiate detoxification: a pilot study of two cohorts totalling 101 patients with a note on naltrexone blood levels , 2003, Addiction biology.

[6]  J. Strang,et al.  Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study , 2003, BMJ : British Medical Journal.

[7]  C. Brewer.  Serum naltrexone and 6‐beta‐naltrexol levels from naltrexone implants can block very large amounts of heroin: a report of two cases , 2002, Addiction biology.

[8]  S. Sunjic,et al.  Methadone-related deaths and mortality rate during induction into methadone maintenance, New South Wales, 1996. , 2002, Drug and alcohol review.

[9]  W. Ling,et al.  Naltrexone and dysphoria: fact or myth? , 2002, The American journal on addictions.

[10]  A. Forrest,et al.  Methadone deaths: a toxicological analysis , 2000, Journal of clinical pathology.

[11]  J. Smialek,et al.  Site Dependence of Postmortem Blood Methadone Concentrations , 1995, The American journal of forensic medicine and pathology.

[12]  K. Bailey,et al.  Sudden unexpected nontraumatic deaths in young adults: A 30-year population-based study , 1991 .

[13]  J. Volavka,et al.  Naltrexone: Disposition, metabolism, and effects after acute and chronic dosing , 1976, Clinical pharmacology and therapeutics.

[14]  E. Streel,et al.  Current Issues in the Use of Opioid Antagonists (Naltrexone for Opiate Abuse: A Re-Educational Tool as Well as an Effective Drug) , 2009 .

[15]  A. Christophersen,et al.  Naltrexone implants -- duration, tolerability and clinical usefulness. A pilot study. , 2006, European addiction research.