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Naltrexone: Factors Contributing to Retention in Treatment

  • R. A. Greenstein
  • J. Grabowski
  • C. P. O’Brien
  • Melody Long
  • G. Woody
  • S. Livingston

Abstract

The narcotic antagonist naltrexone has been evaluated in extensive clinical trials (Bradford, Hurley, Golondzowski, and Dorrier, 1976; Brahen, Capone, Heller, Landy, Linden, and Lewis, in press; Lansberg, Taintor, Plumb, Amico, and Wicks, 1976; Martin, Jasinski, and Mansky, 1973; O’Brien, Greenstein, Mintz, and Woody, 1976). However a variety of factors appear to have contributed to the relatively low acceptance of naltrexone as a treatment form and the short duration of naltrexone maintenance usually observed. Thus at least some of the factors contributing to naltrexone’s desirability from a therapeutic viewpoint result in it being a less preferred treatment agent from the viewpoint of many patients. Several reports (e.g., Callahan, Rawson, Glazer, McCleave, and Arias, 1976; Meyer, Randall, Barrington, Mirin, and Greenberg, 1976; Stitzer and Bigelow, 1975; Wikler, 1976) have described or suggested procedures which might facilitate treatment. It appears that in combination with other approaches naltrexone may serve as a useful adjunct in treatment of opiate users (Brahen et al., in press; Callahan et al., 1976) although no optimal combination has yet emerged (Callahan, Rawson, McCleave, Arias, Glazer, and Lieberman, in press).

Keywords

Methadone Maintenance Opiate Dependence Heroin Dependence Opiate User Narcotic Antagonist 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Blachly, P.H. 1973. Naloxone for diagnosis in methadone programs. Journal of the American Medical Assoication. 224, 334.CrossRefGoogle Scholar
  2. Brahen, L.S., Capone, T., Heller, R.C., Landy, H.J., Linden, S.L., and Lewis, M.J. Controlled clinical study of naltrexone maintenance regimens. (In press).Google Scholar
  3. Bradford, H.A., Hurley, F.L., Golondzowski, O., and Dorrier, C. 1976. Interim Report on clinic intake and safety data collected from 17 NIDA funded naltrexone studies. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  4. Callahan, E., Rawson, R., Glazer, M., McCleave, B., and Arias, R. 1976. Comparison of two naltrexone treatment programs: naltrexone alone versus naltrexone plus behavior therapy. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  5. Callahan, E., Rawson, R., McCleave, B., Arias, R., Glazer, M., and Lieberman, R.P. The treatment of heroin addiction: Naltrexone alone and with behavior therapy. Int. Journal of the Addictions. (In press).Google Scholar
  6. Goldstein, A. 1976. Naltrexone in the management of heroin addiction: critique of the rationale. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  7. Greenstein, R., O’Brien, C.P., Woody, G., Long, M., Coyle-Perkins, G., and Grabowski, J. Naltrexone: defining its place in multi-modality drug treatment. (In preparation).Google Scholar
  8. Hass, N., Ling, W., Holmes, E., Blakis, M., and Litaker, M. 1976. Naltrexone in methadone maintenance patients electing to become “drug free”. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  9. Keegan, J., Lavenduski, C., and Schoof, K. 1976. Comments and findings from a naltrexone double-blind study. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  10. Landsberg, R., Taintor, Z., Plumb, M., Amico, L., and Wicks, N. 1976. An analysis of naltrexone use - its efficacy, safety and potential. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  11. Lewis, D., Hersch, R., Black, R., and Mayer, J. 1976. Use of narcotic antagonists (naltrexone) in an addiction treatment program. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  12. Martin, W.R., Jasinsky, F.P., and Mansky, P.A. 1973. Naltrexone, an antagonist for the treatment of heroin dependence. Archives of General Psychiatry. 28: 784–791.CrossRefGoogle Scholar
  13. Meyer, R., Randall, M., Barrington, B.A., Mirin, S., and Greenberg, I. 1976. Limitations of an extinction approach to narcotic antagonist treatment. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  14. O’Brien, C.P. and Greenstein, R. 1976. Naltrexone in a behavioral treatment program. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  15. O’Brien, C.P., Greenstein, R., Mintz, J., and Woody, G. 1975. Clinical experience with naltrexone. American Journal of Drug and Alcohol Abuse. 2: 365–377.CrossRefGoogle Scholar
  16. Resnick, R. and Schuyten-Resnick, E. 1976. A point of view concerning treatment antagonists. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  17. Stitzer, M. and Bigelow, G. 1975. Contingency management in a methadone maintenance program: availability of reinforcers. International Journal of the Addictions. 13.Google Scholar
  18. Swinyard, E.A. 1975. Principles of prescription order writing and patient compliance instruction. In L. Goodman and A. Gilman (eds.), The Pharmacological Basis of Therapeutics. New York: MacMillan Publishing Co., Inc.Google Scholar
  19. Thomas, M., Kauders, F., Harris, M., Cooperstein, J., Hough, G., and Resnick, R. 1976. Clinical experience with naltrexone in 370 detoxified addicts. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  20. Wikler, A. 1976. The theoretical basis of narcotic addiction treatment with narcotic antagonists. In D. Julius and P. Renault (eds.), Narcotic Antagonists: Naltrexone.Google Scholar
  21. Zifferblatt, S. 1975. Increased patient compliance through the ap- plied analysis of behavior. Preventive Medicine. 4: 173–182.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1981

Authors and Affiliations

  • R. A. Greenstein
    • 1
  • J. Grabowski
    • 1
  • C. P. O’Brien
    • 1
  • Melody Long
    • 1
  • G. Woody
    • 1
  • S. Livingston
    • 1
  1. 1.University of Pennsylvania and Veterans Administration HospitalUSA

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