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A systematic review on the efficacy of naltrexone maintenance treatment in opioid dependence
Author(s) -
Kirchmayer Ursula,
Davoli Marina,
Verster Annette D.,
Amato Laura,
Ferri Arica,
Perucci Carlo A.
Publication year - 2002
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1046/j.1360-0443.2002.00217.x
Subject(s) - naltrexone , detoxification (alternative medicine) , methadone , medicine , opioid , heroin , placebo , randomized controlled trial , methadone maintenance , clinical trial , meta analysis , narcotic antagonist , addiction , psychiatry , opiate , relapse prevention , anesthesia , alternative medicine , drug , receptor , pathology
Aim To evaluate the efficacy of naltrexone maintenance treatment in preventing relapse in opioid addicts after detoxification. Design A systematic review according to the methodology developed by the Cochrane Collaboration based on either randomized controlled trials (RCTs) or controlled clinical trials (CCTs). Participants Seven hundred and seven heroin dependent in‐ and out‐patients, or former heroin addicts dependent on methadone and participating in a naltrexone treatment programme; 89% were male. Intervention Maintenance treatments on opiate dependent people after detoxification, comparing naltrexone with placebo, pharmacological or behavioural treatments. Measurements The outcomes considered were successfully completed treatment, opioid use under treatment (re)‐incarcerations during the study period, mean duration of treatment. Findings The outcomes tended to be slightly although not significantly in favour of the naltrexone groups. Use of naltrexone in addition to behavioural treatment significantly decreased the probability of (re‐)incarceration (OR=0.30; 95% CI 0.12, 0.76). The difficulties in producing a quantitative analysis were due mainly to the heterogeneity of the included studies. Conclusions From the available clinical trials performed up to this time, there is insufficient evidence to justify the use of naltrexone in maintenance treatment of opioid addicts.