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The Utilization of Low Dose Naltrexone for Chronic Pain

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Abstract

Naltrexone is a mu-opioid receptor antagonist with a long half-life compared with naloxone. Both of these drugs, along with others, were developed with the intention of reversing the effects of opioid abuse or toxicity. Evidence has also shown that naltrexone has a benefit in preventing relapse by reducing opioid cravings and reducing symptoms of opioid withdrawal. The benefits of this drug were not only shown with opioid abuse. In 1984 this drug was also approved for alcohol abuse. Naltrexone has been proven to decrease alcohol relapse by decreasing the craving. Apart from these approved indications for the use of naltrexone, with time, it has been seen that this drug has a benefit in treating chronic pain. A number of studies have shown the benefits of this drug with inflammatory bowel disease, fibromyalgia, multiple sclerosis, diabetic neuropathy, and complex regional pain syndrome, among others. More studies are needed to approve this medication for specific chronic pain conditions.

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Authors and Affiliations

  1. Department of Anesthesiology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL, USA

    Salomon Poliwoda

  2. Creighton University School of Medicine Phoenix, Phoenix, AZ, USA

    Bryant Noss, Gia Thinh D. Truong & Zachary A. Creech

  3. Department of Anesthesiology and Pain Medicine, Valleywise Health Medical Center, Creighton University School of Medicine Phoenix, Phoenix, AZ, USA

    Sarang S. Koushik

  4. Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA

    Ivan Urits

  5. Southcoast Health Physicians Group, Southcoast Health Pain Management, Wareham, MA, USA

    Ivan Urits

  6. Innovative Pain and Wellness, Scottsdale, AZ, USA

    Omar Viswanath

  7. Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA

    Omar Viswanath

  8. Department of Anesthesiology, Creighton University School of Medicine, Phoenix, AZ, USA

    Omar Viswanath

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  1. Salomon Poliwoda
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Correspondence to Salomon Poliwoda.

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The authors S.P., B.N., G.T.D.T., Z.A.C., S.S.K., I.U., and O.V. have no conflicts to declare.

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Author Contributions

Salomon Poliwoda MD: First author, collected references, and organized structure of this review. Bryant Noss B.S.: His main focus was the introduction. Gia Thinh D. Truong B.S.: Her main focus was the section regarding naltrexone and its pharmacology. Zachary A. Creech B.S., Sarang S. Koushik MD: Their main focus was the section regarding naltrexone and chronic pain. Ivan Urits MD, Omar Viswanath MD: Their focus was editing, reviewing, and guiding the review.

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Poliwoda, S., Noss, B., Truong, G.T.D. et al. The Utilization of Low Dose Naltrexone for Chronic Pain. CNS Drugs 37, 663–670 (2023). https://doi.org/10.1007/s40263-023-01018-3

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