A New Hope for Naltrexone in Managing Opioid Dependence

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In a survey of substance abuse-related hospital admissions taken by the Substance Abuse and Mental Health Services Administration (SAMHSA), a total of 26% of all admissions surveyed were due to primary opioid addiction. Of the 1.7 million cases surveyed, this percentage represents just under half a million cases in which opioid misuse was the primary issue [1]. This staggering proportion underscores the prevalence of opioid dependence in the US and begs the question of what is being done to help those struggling against opioid dependence.

 

One approach to assisting individuals recovering from opioid addiction has been to treat with a maintenance drug. A maintenance drug is a drug prescribed by a healthcare professional that helps reduce the cravings for opioids that often lead to relapse. Current treatments include methadone and buprenorphine, both of which can be thought of as substitute agents for the more addictive substances. While these types of therapies can often help reduce cravings and prevent withdrawal effects, they still carry the risk of abuse due to their pharmacological similarity to morphine and other opioids.

 

Naltrexone, a drug that works to block the receptors that mediate the addictiveness of opioids, has been tested previously as an agent to help patients maintain abstinence from opioid abuse. While its oral form demonstrates some efficacy, its clinical use has been limited due to issues with patient compliance [2]. Two recent studies from groups in the US and Norway have tested a new, injectable version of naltrexone that has shown promise compared to current standards of care [3, 4]. While relapse rates remain high among those recovering from opioid abuse, the continued development of pharmacotherapies in helping to reduce cravings is crucial in the effort to help these patients win back their independence [5].

 

David Shia

Staff Writer, Signal to Noise Magazine

MD/PhD Candidate in Molecular Biology Interdepartmental Doctoral Program, UCLA

 

 

References:

[1] Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2002-2012. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-71, HHS Publication No. (SMA) 14-4850. Rockville, MD: Substance Abuse and Mental Health Services Administration (2014).

 [2] Bart, G. Maintenance medication for opiate addiction: the foundation of recovery. Journal of Addictive Diseases 31(3), 207-225 (2012).

[3] Tanum, L., et al. Effectiveness of Injectable Extended-Release Naltrexone vs Daily Buprenorphine-Naloxone for Opioid Dependence: A Randomized Clinical Noninferiority Trial. JAMA Psychiatry 74(12), 1197-1205 (2017).

[4] Lee, J. D., et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X: BOT): a multicentre, open-label, randomised controlled trial. The Lancet 391(10118), 309-318 (2017).

[5] Smyth, B. P., Barry, J., Keenan, E., & Ducray, K. (2010). Lapse and relapse following inpatient treatment of opiate dependence. Irish Medical Journal 103(6), 176-179 (2010).