Withdrawal syndrome caused by naltrexone in opioid abusers

Hassanian‐Moghaddam, Hossein; Afzali, Saeed; Pooya, A

doi:10.1177/0960327112450901

Cited by 25 publications

(22 citation statements)

References 14 publications

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“…In opioid‐dependent patients, it may be relevant. There are reports on naltrexone‐induced withdrawal syndrome in opioid‐dependent patients . On the other hand, it is suggested that opioid antagonists in low doses are useful in the treatment of opioid withdrawal .…”

Section: Discussionmentioning

confidence: 99%

Low-dose naltrexone and opioid consumption: a drug utilization cohort study based on data from the Norwegian prescription database

Raknes

Småbrekke

2017

Pharmacoepidemiol Drug Saf

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PurposeLow‐dose naltrexone (LDN) is used in a wide range of conditions, including chronic pain and fibromyalgia. Because of the opioid antagonism of naltrexone, LDN users are probably often warned against concomitant use with opioids. In this study, based on data from the Norwegian prescription database, we examine changes in opioid consumption after starting LDN therapy.MethodsWe included all Norwegian patients (N = 3775) with at least one recorded LDN prescription in 2013 and at least one dispensed opioid prescription during the 365 days preceding the first LDN prescription. We allocated the patients into three subgroups depending on the number of collected LDN prescriptions and recorded the number of defined daily doses (DDDs) on collected prescriptions on opioids, nonsteroidal anti‐inflammatory drugs and other analgesics and antipyretics from the same patients.ResultsAmong the patients collecting ≥4 LDN prescriptions, annual average opioid consumption was reduced by 41 DDDs per person (46%) compared with that of the previous year. The reduction was 12 DDDs per person (15%) among users collecting two to three prescriptions and no change among those collecting only one LDN prescription. We observed no increase in the number of DDDs in nonsteroidal anti‐inflammatory drugs or other analgesics and antipyretics corresponding to the decrease in opioid use.ConclusionsPossibly, LDN users avoided opioids because of warnings on concomitant use or the patients continuing on LDN were less opioid dependent than those terminating LDN. Therapeutic effects of LDN contributing to lower opioid consumption cannot be ruled out. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 99%

Low-dose naltrexone and opioid consumption: a drug utilization cohort study based on data from the Norwegian prescription database

Raknes

Småbrekke

2017

Pharmacoepidemiol Drug Saf

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“…It provokes feelings of confidence and independence. High self esteem is associated with greater problem-solving skills and higher ability to analyze problematic situations ( 14 - 18 ).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Family-Centered Problem-Solving Education on Relapse Rate, Self Efficacy and Self Esteem Among Substance Abusers

Habibi

Nasrabadi

Hamedan

et al. 2016

Int J High Risk Behav Addict

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Background:The success of drug abuse treatment and relapse prevention methods depends widely on not only pharmaceutical and non-pharmaceutical therapies but also self efficacy and self esteem promotion.Objectives:The current study attempted to clarify the effects of Problem Solving Education (PSE) on relapse rate, self efficacy and self esteem among drug abusers.Patients and Methods:This non-controlled clinical trial (quasi-experimental) assessed 60 opium and heroin abusers who were willing to quit and were referred to the Mehr Center of Addiction Treatment and Rehabilitation Facility. The patients were allocated to two groups of 30 (intervention and control groups). While both groups received the routine care of the clinic, the intervention group also attended eight 45-minute family-centered PSE sessions. The Coopersmith Self esteem Inventory and Quit Addiction Self efficacy Questionnaire were filled out for all subjects before and after the intervention. Drug relapse was investigated four times with two-week intervals. The two groups were compared using chi-square and Student’s-t tests. Logistic regression analysis was applied to determine factors affecting drug relapse.Results:A total of 45 individuals (21 and 24 in the intervention and control groups, respectively) completed the study. At baseline, the two groups had no significant difference regarding their mean scores of self esteem and self efficacy (P = 0.692 and 0.329, respectively). After the intervention, however, the mean changes of self esteem scores were 20.10 ± 3.75 for the intervention group and 4.50 for the control group (P < 0.001). The mean changes of self efficacy scores in the mentioned groups were 34 34.17 ± 5.19 and 9.03± 2.04, respectively (P < 0.001). Drug relapse after two weeks was correlated with age (OR = 1.216; P = 0.026; 95% CI: 1.024-1.445) and implementation of the intervention (OR = 0.036; P = 0.003; 95% CI: 0.004-0.322).Conclusions:According to our findings, supplementing drug abuse treatment with cognitive behavior therapy, particularly PSE, can reduce relapse rate and enhance self efficacy and self esteem among patients.

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“…Naltrexone will induce opiate withdrawal in the setting of opiate analgesic use, a severe but nonfatal condition that still may require hospitalization. 58 Chronic pain patients should be carefully screened for opiate pain medication use, prescribed or otherwise. If the patients are not on an opiate pain medication, the combination drug can be used with the caveat that it will block antinociceptive effects of opiates if they are required in future.…”

Section: Special Patient Populationsmentioning

confidence: 99%

Naltrexone HCI/bupropion HCI for chronic weight management in obese adults: patient selection and perspectives

Tek¹

2016

PPA

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Naltrexone, an opiate antagonist, and bupropion, a noradrenergic/dopaminergic antidepressant, have many effects on the reward systems of the brain. These medications impact eating behavior, presumably via their impact on food reward. However, only bupropion induces weight loss in obese individuals, while naltrexone does not have any appreciable effect. The combination of 32 mg of naltrexone and 360 mg of bupropion in a sustained-release combination pill form has been recently approved for obesity treatment. Studies have shown that the combination of these two medications is more effective in inducing weight loss, when combined with lifestyle intervention and calorie reduction, than each individual medicine alone. The naltrexone–bupropion combination, when combined with lifestyle intervention and modest calorie reduction, seems to be quite effective for 6-month and 1-year outcomes for clinically significant weight loss (over 5% of total body weight). These medications are not devoid of serious side effects, however, and careful patient selection can reduce dramatic complications and increase positive outcomes. This paper reviews existing weight loss clinical trials with bupropion and the bupropion–naltrexone combination. Additionally, the rationale for the suggested patient selection and clinical strategies for special patient populations are discussed.

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Withdrawal syndrome caused by naltrexone in opioid abusers

Cited by 25 publications

References 14 publications

Low-dose naltrexone and opioid consumption: a drug utilization cohort study based on data from the Norwegian prescription database

Low-dose naltrexone and opioid consumption: a drug utilization cohort study based on data from the Norwegian prescription database

The Effects of Family-Centered Problem-Solving Education on Relapse Rate, Self Efficacy and Self Esteem Among Substance Abusers

Naltrexone HCI/bupropion HCI for chronic weight management in obese adults: patient selection and perspectives

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