Naltrexone for heroin addiction

Heroin addicts are often prescribed methadone as this reduces problems with criminality, contaminated drugs and dirty needles. However, methadone itself is still addictive so Nikolaj Kunoe from the Norwegian Centre for Addiction Research at the University of Oslo looked into the use of a substance called naltrexone. Naltrexone completely blocks the effects of heroin and other morphine-related substances. Kunoe studied 56 heroin addicts who had already been through detoxification treatment. Half of them were implanted with 20 subcutaneous pellets containing naltrexone which was gradually released into the bloodstream and half received treatment as usual. After six months twice as many people in the naltrexone group managed to give up heroin and those who did not give up heroin more than halved their use. By contrast in the control group the majority of people relapsed back into heroin use.

Naltrexone and alcoholism

Naltrexone is used in the treatment of alcoholism. It blocks the pleasurable feelings people get from drinking alcohol and reduces the motivation to drink. Michael Soyka and Suanne Roesner from the University of Munich reviewed 50 studies into the effectiveness of naltrexone covering a total of nearly 7,800 participants. They found that, compared to a placebo, people taking naltrexone were 17% less likely to return to heavy drinking. The trials tested naltrexone used in conjunction with counselling or a 12-step programme, like Alcoholics Anonymous, and the authors of the study warned that although it might help some people, it was not a miracle cure.

Naltrexone cuts costs of drink problems

Oral naltrexone can significantly reduce the healthcare costs associated with alcohol. It is estimated that around one in twelve people in the U.S. has a drink problem, something that cost an estimated $185bn in 1998. Researchers, led by Henry R. Kranzler from the University of Connecticut, studied 7,959 people over a six-month period and found that people with alcohol problems who took naltrexone had significantly lower healthcare costs than people with alcohol problems who did not take the drug.

You can find out more about this research at

http://www.sciencedaily.com/releases/2010/04/100405174938.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

Naltrexone and dual diagnosis

Naltrexone is often used to treat drug addicts and alcoholics. People with schizophrenia often have problems with drug use as well and Ileana Berman from Harvard Medical School led a small-scale study of 37 people to see whether naltrexone could help in treating people with schizophrenia. Over six months half of the study participants were given naltrexone and half were given a placebo. The study found that the participants taking naltrexone actually did worse than those on a placebo suggesting that antipsychotic drugs, psychotherapy and social support are still the best treatment for people with schizophrenia.

You can find out more about this research at

http://www.medicalnewstoday.com/articles/181575.php

Long-lasting naltrexone for heroin addicts

A drug called naltrexone is used to treat heroin addicts as it blocks the receptors heroin uses to generate its effect. Unfortunately the effectiveness of naltrexone can be limited as people often forget to take it orally. One way round this problem is to use a long-lasting injection which delivers the drug gradually into the bloodstream. A team of researchers from Australia compared the effectiveness of a long-lasting injection with that of oral naltrexone in a study of 70 heroin addicts. As well as comparing the injections to oral naltrexone the researchers also compared both treatments to a placebo. The study found that the implant led to higher levels of the drug in people's bloodstreams, fewer people returning to heroin use and people going longer before relapsing.

Hulse, Gary K. ... [et al] - Improving clinical outcomes in treating heroin dependence Archives of General Psychiatry October 2009, 66(10), 1108-1115

Naltrexone hits the target for drinking problems

The drug naltrexone is used in the U.S. for the treatment of alcohol dependence. The largest study of its effectiveness so far showed that it decreased the risk of a relapse into heavy drinking by around 36%. However, naltrexone also has a number of unpleasant side effects including nausea, dizziness and fatigue. Researchers from the University of Connecticut looked into the effectiveness of 'targeted' doses of naltrexone i.e. taking it when cravings were particularly strong or before 'triggering' situations. Half of the 163 people in the study took naltrexone daily and half took it on a targeted basis and within the two groups half of the participants were given a placebo. The men taking targeted naltrexone drank less drinks per day on average and both sexes taking targeted naltrexone dranks less drinks per drinking day.

Kranzler, Henry R. ... [et al] - Targeted naltrexone for problem drinkers Journal of Clinical Psychopharmacology August 2009, 29(4), 350-357

Long-acting naltrexone shows promising results for heroin addicts

There is a lot of research suggesting that the drug naltrexone blocks the action of heroin in the body yet its clinical usefulness has proved limited. This could be because many people are reluctant to take the drug or start taking it and then stop. Longer-lasting injections of naltrexone could get around some of these difficulties. Preliminary studies have been encouraging and a study of 56 heroin addicts by researchers in Norway has also proved promising. The group was divided into two with half receiving the long-lasting naltrexone and half receiving the usual treatment for heroin addicts. Those participants who received naltrexone had, on average, 45 days less heroin use than the other participants. The naltrexone stayed in the participants' bloodstreams throughout the study. Unfortunately two patients in the control group (but none among those taking naltrexone) died during the course of the study.

Kunoe, Nikolaj ... [et al] - Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial British Journal of Psychiatry June 2009, 194(6), 541-546

Naltrexone and kleptomania

Naltrexone is used to treat people with alcohol and drugs problems but it could also help people with kleptomania as well. Researchers at the University of Minnesota tested it for two months on 25 people who said they spent at least one hour a week stealing. Those who took naltrexone reported significantly less stealing behaviour compared to those given a placebo.

You can find out more about this research at

http://uk.reuters.com/article/healthNews/idUKTRE52U82820090331?feedType=RSS&feedName=healthNews&rpc=401

Naltrexone helps with smoking and drinking

Naltrexone is a drug used to treat people with alcohol problems. Alcohol and nicotine stimulate the same reward pathways in the brain and a study of 78 people by researchers at the University of Chicago has found that it can also help heavy social drinkers who smoke give up tobacco and cut down on their drinking. The participants in the study had a range of drinking behaviour from total abstinence to heavy social drinking; half of them were given naltrexone and half were given a placebo. The study found that 50mg of naltrexone daily, together with a nicotine patch and counselling, significantly decreased heavy drinking rates and the participants who drank the most were most likely to quit smoking as well.

You can find out more about this research at

http://www.sciencedaily.com/releases/2009/03/090319161458.htm

Adolescents, drink, and drugs therapy

Alcohol dependence is a common problem in adolescents with both regular and binge-drinking patterns occuring. Adults often have drug treatment, along with psychotherapy, for alcohol problems but little research has been done into drug therapy for adolescents with drink problems. An Indian study of 58 adolescents divided them into two groups. One group received disulfiram while the other group received naltrexone and the study lasted for six months. The adolescents who had a relapse lasted longer (84 days on average) before relapse when taking disulfiram, than when taking naltrexone (average 51 days). Nearly 80% of participants taking disulfiram remained abstinent compared to just over 50% of those taking naltrexone. However, those taking naltrexone had less cravings for alcohol than those taking disulfiram. The researchers concluded that more research needed to be done into the effectiveness of these drugs with larger samples of participants in a variety of settings.

De Sousa, Avinash and De Sousa, Alan - An open randomized trial comparing disulfiram and naltrexone in adolescents with alcohol dependence Journal of Substance Use December 2008, 13(6), 382-388

Naltrexone for gambling problems

It is estimated that between 1 and 3% of the population has a gambling problem. The principal treatments for gambling problems are usually psychological but a new study by researchers at the University of Minnesota has found that a drug usually used to treat alcoholism can also help gamblers. The study, of people between the ages of 18 and 75 who gambled between six and thirty-two hours a week, compared the drug naltrexone to a placebo. By the end of the 18-week trial 40% of those taking naltrexone had quit gambling for at least a month, compared to only 10% of those taking the placebo. Naltrexone had few side effects and was equally effective in men and women.

You can find out more about this research at

http://psychcentral.com/news/2008/06/16/alcoholism-drug-helps-pathological-gamblers/2464.html

Alchoholism, genes and naltrexone

Alcohol increases the release of the endogenous (produced by the body) opioids beta-endorphin and enkephalin in animals and humans. Blocking opioid receptors in the brain with naltrexone leads to less alcohol-induced pleasure, high and intoxication and ultimately less craving and relapse for alchoholics. However, not all individuals with alcohol dependence respond to naltrexone. A team of researchers in the U.S. looked at the effects of a pair of genes called Asp40 and Asn40 on the effectiveness of naltrexone for the treatment of alcoholism. People can have either two Asp40 genes, two Asn40 genes or one of each. The researchers studied 604 alcoholics and found that those with the Asp40/Asp40 combination showed an increased percentage of days abstinent and a decreased percentage of heavy drinking days when treated with naltrexone rather than a placebo. However, those with ths Asn40/Asn40 combination fared no better on naltrexone than on a placebo.

Anton, Raymond F. ... [et al] - An evaluation of u-Opioid receptor (OPRM1) as a predictor of naltrexone response in the treatment of alcohol dependence: results from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study Archives of General Psychiatry February 2008, 65(2), 135-144

Drinking, depression and naltrexone

People with drink problems often suffer from depression as well. People who suffer from depression are more likely to drink heavily and people who drink heavily are more likely to suffer from depression. Those people with drink problems and depression have increased treatment dropout rates, higher rates of relapse, greater levels of alcohol consumption and more use of medical services. Naltrexone is used to treat people with alcohol problems but there has not been much research into its effectiveness in drinkers with depression or how its effectiveness is affected by interactions with antidepressants. A U.S. study of 627 people being treated for alcohol problems found that there was no difference in the effectiveness of naltrexone in people taking antidepressants and that it helped to reduce the number of days' drinking in people taking depression medication.

Krystal, John H. ... [et al] - Naltrexone is associated with reduced drinking by alcohol dependent patients receiving antidepressants for mood and anxiety symptoms : results from VA cooperative study no. 425 "Naltrexone in the treatment of alcoholism" Alcoholism : clinical and experimental research January 2008, 32(1), 85-91