Oral naltrexone maintenance treatment for opioid dependence

Additional influences on provision of mental health services

“…It is naive to trust that legislation will inevitably solve these problems and there is justified concern that hidden indirect discrimination could drive us in the wrong direction. 3 The law of unintended consequences is well known and is the reason why professional position statements and guidance remain important. Access to services is not sufficient to ensure equality.…”

“…Finally, there is need to address an increasing mental health workforce gap, 3,4 where the greatest need for specialist expansion is in old age psychiatry, 5 yet it has the highest vacancy rate in specialist training, and to redress previous policy discrimination against older people by positive action. 3 The Welsh politician Aneurin Bevan described priority as the language of politics and so today's health and social care language is older people.…”

“…3,4 Job was depressed because the Lord had allowed Satan to have his children killed, his livestock driven off and his body to be covered with boils. He felt this was unjustified according to the current philosophy of retributive justice, so he was angry with God.…”

Substance Abuse Treatment Utilizing Medication Assisted Treatment as HIV Prevention

“…Naltrexone is a non-narcotic and therefore non-controlled medication for the treatment of opioid abuse as well as alcohol abuse. Naltrexone integrated with mental health services, particularly psychosocial treatment has been shown to be an effective maintenance treatment for reducing heroin use after detoxification (Minozzi et al 2006). In addition, using clonidine and naltrexone together has been shown to be successfully integrated into a primary care setting (O'Connor et al 1997).…”

Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery

“…91 However, medication compliance and retention rates remain poor (28%), particularly during early stages of recovery. 92 This is likely explained by unwanted side effects such as sedation (for example, daytime sleepiness) and gastrointestinal problems (for example, nausea, stomach pain, loss of appetite). 90 Extended-release naltrexone has thus been developed and used, with success, to improve adherence over and above other pharmacotherapies used in the treatment of alcohol and opioid dependence (for example, acamprosate, buprenorphine).…”