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• W299402011 abstract "Abstract Objective: Naltrexone is reported to be a reasonably effective treatment for relapse prevention for patients with opioid dependence. However, there is a lack of data on outcome and acceptability for Indian patients. Patients and Methods: A prospective, longitudinal, open-label, intent-to-treat study was performed in which 106 patients with opioid dependence were given naltrexone 50 mg daily for 6 months. Results: Fifty eight patients (55%) were followed up and reassessed after 6 months. The follow-up and drop-out groups were comparable. Using last outcome carried forward analysis, the overall abstinence rate was 52% (55 of 106 patients). Side effects were uncommon, mild, and transient, with bitter taste being the commonest, and there was no hepatic dysfunction. Level of satisfaction and perception regarding naltrexone as treatment for opioid dependence was reported to be satisfactory and reasonably high by the patients and their attendants/relatives, respectively. Conclusion: Naltrexone appears to be an acceptable treatment for opioid-dependent patients in India. However, controlled and randomised trials are warranted to evaluate associated factors. Key words: Acceptability, Naltrexone, Opioid dependence, Outcome Introduction Opioid dependence is a significant medical and social problem, with such patients being at significant risk for developing human immunodeficiency virus and hepatitis. (1) A promising treatment for relapse prevention in patients with opioid dependence is naltrexone. Naltrexone is a long-acting competitive opioid antagonist that blocks the reinforcing effects of opioids and eliminates opioid self-administration. (2) It is reported to be well tolerated with few or no agonist effects at therapeutic doses. (1) Numerous open-label, placebo-controlled, and double-blind trials of naltrexone have been performed. (1,3,4) However, due to variable sample sizes and outcome parameters, the results obtained have been ambiguous in terms of the clinical effectiveness of naltrexone for relapse prevention. (2,3) The major limitations associated with naltrexone are low retention rates, with most patients stopping treatment within 2 months, (4) and absence of studies assessing outcome and compliance at or beyond 6 months. Many studies are available from the West assessing the efficacy and retention rates with naltrexone. Outcomes have been fair to good with retention rates ranging from 0% to 50%. (4) A recent study from China reported abstinence rates of approximately 25% using both double-blind and open-label methodologies. (5) However, there is only 1 study from India evaluating the efficacy of 3 months of naltrexone maintenance therapy for opioid dependence. (6) This is intriguing, bearing in mind the high prevalence (and associated complications) of opioid dependence in India where methadone maintenance therapy for opioid dependence is not available. Also, use of buprenorphine sublingual tablets is not regular, the cost is reasonably high, and efficacy studies are lacking. Naltrexone, on the other hand, has been available in India for at least 5 years. Although, the high price during the initial years precluded its use by clinicians and patients alike, the cost has substantially reduced in the past 24 months. In India, naltrexone is frequently used as a relapse prevention strategy for opioid dependence. However, the efficacy, outcome, and retention rates are unknown, highlighting the importance of developing a database of the efficacy and acceptability of naltrexone therapy in India. With these issues in mind, this study, with an openlabel, naturalistic treatment design, was planned to broadly assess the acceptability of naltrexone for opioid-dependent patients in India. The following are the objectives of the study: * to characterise the acceptance of naltrexone for relapse prevention of patients with opioid dependence * to compare the follow-up and drop-out groups * to evaluate the acceptability and tolerability of naltrexone during a 6-month period. …" @default.
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• W299402011 date "2003-12-01" @default.
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• W299402011 title "Acceptability of Naltrexone by Patients with Opioid Dependence: an Indian Perspective" @default.
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