Naltrexone Implant for Preventing Opioid Addiction Relapse
Naltrexone Implant for Preventing Opioid Addiction Relapse
Naltrexone is an opioid antagonist which blocks the effects of opioids and alcohol in the brain at a receptor level. This helps to curb abuse, prevent relapse, and sustain recovery from opioid addiction as well as alcoholism.
The lure of heroin, prescription painkillers and other narcotic drugs are all too familiar for many individuals struggling with addiction.
Opioids are drugs that reduce pain in the body and produce effects similar to those of morphine.
Examples of opioids include heroin, morphine and prescription painkillers such as Vicodin, OxyContin and Percocet. These drugs may give the impression of providing a temporary shelter where the user can escape pain, stress and fear — at least for a little while.
However, those who have gone down this path quickly learn that the drug that once provided them with an escape from personal struggles soon becomes the greatest struggle of their lives.
Giving up access to a drug that can cause such a crippling dependency isn’t easy – even when your opiate use is destroying your relationships, your family life, your job and your sense of who you are.
What Are Naltrexone Implants?
Naltrexone implants are small medication pellets that get inserted under the skin and slowly release the medication over varying lengths of time – usually from 2 to 6 months. Oral tablet and injection forms of naltrexone are currently used in the U.S. for treating opioid dependence. While it has been used in Europe and Australia, the implantable version of naltrexone has not yet been approved by the FDA for use in the U.S.
What Does Naltrexone Do?
Naltrexone is a prescription drug belonging to a class of drugs called opioid antagonists. It functions by blocking some of the effects of both opioids and alcohol at a brain cell receptor level.
What does this mean? Simply put, if you take opioid medications or use street drugs (e.g., heroin) while using naltrexone, the euphoric effects of the drug will be minimized or blocked.
In combination with therapy and behavioral modification, naltrexone can help reduce the desire for drugs such as1:
What Does Naltrexone Not Do?
Naltrexone can make it easier to get through the recovery process by helping you avoid those powerful opioid cravings that can drive you back to using.
But naltrexone doesn’t treat the withdrawal symptoms that opioid users may experience, including:
- Sleep disturbances.
- Abdominal pain.
- Muscle cramps.
Opioid withdrawal symptoms usually aren’t life threatening, but they can be so unpleasant and disturbing that they discourage a lot of individuals from entering recovery.1 Although naltrexone doesn’t relieve these symptoms, it can make it easier to stick with your recovery goals.
While it is a helpful treatment tool, naltrexone doesn’t “cure” opiate addiction, and the drug won’t be effective unless you are motivated to recover.
Other Forms of Naltrexone
Naltrexone is available with a doctor’s prescription and should only be used as part of a medically supervised addiction treatment program. Naltrexone is a versatile drug that can be taken in a few different forms in addition to the implantable form:
- By mouth as a tablet.
- By monthly injections of an extended release suspension.
Why Choose an Implant?
When taken as a pill, naltrexone can be very effective at minimizing cravings and preventing a relapse. However, a lot of individuals who use drugs either forget to take the medication or deliberately avoid taking the pill in order to get the high that they crave.
1. Some People Benefit More Than Others
A naltrexone implant may be a good choice for you if:
- You have a history of relapsing.
- The circumstances of your life make it difficult to stay consistent with oral medication.
2. Implants Last a Long Time
Once the implant has been surgically placed under your skin, the drug will continue to be effective for 2-6 months, depending on what you and your healthcare provider decide will be best for your circumstances.
3. Research Suggests Implants are Effective
While more research is needed to further substantiate the findings, there has been an array of studies indicating that naltrexone implants may indeed be a successful means for recovering from opioid dependence.
Success in Norway
In one study published in the British Journal of Psychiatry, 56 patients at an addiction research center in Norway were given the naltrexone implant for treatment of heroin dependence.2 Researchers found that study participants who used the naltrexone implant for 180 days had an average of 45 fewer days of heroin use than members of the control group – and 60 fewer days of opioid use than members of the control group.
Success Across 9 Research Studies
Similarly, a 2014 systematic review published in the Drug and Alcohol Review examined a variety of research results from 9 studies comparing naltrexone implant treatment to either oral naltrexone or to no treatment at all (a placebo).3
Across the 9 studies, naltrexone implants were found to be:
- Significantly more effective than oral naltrexone.
- Significantly more effective than having no treatment at all.
Since the quality of these studies was evaluated as being “moderate to very low,” more research is still needed to better determine the effectiveness of naltrexone implants. However, the data so far suggests that naltrexone implants appear to improve addiction recovery success compared to taking naltrexone pills and compared to attempting to quit an addiction without any medication help.
After having an implant placed, you’ll still need to check in with your doctor regularly. You’ll also need to continue individual or group therapy as part of your recovery. This long-lasting solution may give you greater peace of mind about the stability of your recovery and help you focus your energies on modifying your behavior and rebuilding your life.
Are There Dangers to Naltrexone Implants?
Naltrexone implants have generally been reported as being a safe means for reducing opioid use.2,3 Risks may still be present, however, and complications from naltrexone implants may include any of the following:
- Implantation site complications.
- Withdrawal symptoms, if you haven’t completely detoxed at the time you started treatment.
In a study published in the British Journal of Psychiatry, two of the patients who had a naltrexone implant placed had to have the pellet removed because of infection at the implantation site.2 One patient reported pain at the surgical site, and another reported diarrhea. Naltrexone may not prevent some grave developments, including coma and death, in situations where a user deliberately overdoses on opiates or alcohol in order to overcome its antagonizing effects.
Naltrexone Implants During Pregnancy
In the U.S., women who are pregnant or nursing are advised not to take naltrexone. Limited studies have been conducted on the safety and effectiveness of naltrexone implants during pregnancy, although there are a couple of studies that have helped start the investigation process.
Promising Success and Safety
One study published in a 2002 issue of the Australian and New Zealand Journal of Obstetrics and Gynaecology indicates that the implant has potential as a tool for managing opiate addiction in pregnant women4:
- 8 pregnant, opioid-dependent women at an Australian addiction research center used the naltrexone implant to manage their addiction during pregnancy.
- Study participants had previously tried oral naltrexone without long-term success.
- Using the naltrexone implant, the women were able to remain free from heroin during their pregnancies.
- Neither the women nor their babies had adverse outcomes during or after childbirth.
Possible Neurochemistry and Behavior Changes in Adult Offspring
An Australian study using rats was conducted 10 years later in 2012 and showed potential changes in neurochemistry and behavior in adult offspring of those who’d used naltrexone implants during pregnancy.5 Results showed that exposure to naltrexone was associated with:
- Lowered activity in an area of the brain that controls motor activity (basal ganglia) in adult offspring.
- Heightened drug-seeking behaviors when triggered by cues.
- Heightened responsiveness to morphine.
Further studies are needed to follow up on adults who were exposed in utero to naltrexone.
Stefanie’s Story: A Naltrexone Implant During Pregnancy
Stefanie was 16 years old when she started to experiment with opiates. Her best friend’s mother suffered from chronic back pain caused by an old injury, and Stefanie and her friend used to sneak her mom’s prescription pain pills. After Stefanie graduated from high school and entered a nursing program at her local college, she gave up drugs and alcohol and dedicated herself to her studies.
The Return to Painkiller Addiction
After earning her degree and getting her first job on a busy hospital unit, Stefanie turned back to prescription drugs. Her supervisor suspected that Stefanie might be diverting pain medications from her patients, but she lacked enough evidence to back up her suspicions.
As Stefanie’s life spiraled out of control, her drug use got worse. Terrified of being caught and losing her nursing license, she stopped diverting pain meds, but she couldn’t tolerate the cravings and withdrawal symptoms. Instead of entering a medical treatment program, she turned to street drugs. Before long, occasional heroin use turned into a regular habit.
Pregnancy Motivates Addiction Recovery
If she hadn’t discovered that she was pregnant, Stefanie might have continued using, lost her license and faced criminal charges. Finding out that she was going to have a baby was the wakeup call that changed her life. She voluntarily took a leave of absence from her job and entered an inpatient rehab program, where she successfully made it through detox.
Naltrexone Implant Promotes Lasting Success
After her baby was born, Stefanie was determined not to relapse. Because of her history of turning to drugs at times of stress, she decided to try the naltrexone implant instead of oral medication. Her doctor advised her that if she was going to use the implant, she shouldn’t breastfeed her baby. Stefanie was so worried about the possibility of losing her child that she decided to bottle-feed her baby rather than risk a relapse.
She continued to see her therapist every week and attended 12-step meetings daily. One year after having the first implant placed, Stefanie was living independently, working at a family clinic and raising a healthy baby girl.
Is the Naltrexone Implant Available in the US?
Naltrexone is sold under the brand names Depade, ReVia and Vivitrol, and in the United States, this drug is usually taken in these oral or extended release, intramuscular injectable forms. The U.S. Food and Drug Administration (FDA) has not approved the naltrexone implant, which is surgically inserted under the skin and left in place for 2 to 6 months. However, the medicated pellet has already been used in Australia and Europe, and clinical studies of the naltrexone implant have shown promising results.
Finding Treatment for Your Addiction
The use of the naltrexone implant in the U.S. is still controversial, and finding a doctor in your area who can place the implant may be difficult to impossible. Some opiate-dependent patients have traveled far from home to get this form of addiction treatment. Meanwhile, oral and injectable naltrexone are widely available at treatment centers in the US.
If you need help finding a treatment center, you can contact us today at 1-888-744-0789 Who Answers?, and we’ll be happy to discuss naltrexone implants and other addiction treatments further with you. When it comes to planning your treatment, it’s wise to understand all your options so that you can pick the best treatment methods for your unique circumstances.
- Opiate withdrawal. National Institutes of Health.
- Kunoe, N., Lobmaier, P., Vederhus, J. K., Hjerkinn, B., Hegstad, S., Gossop, M., et al. (2009). Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial. The British Journal of Psychiatry, 194(6), 541-546.
- Larney, S., Gowing, L., Mattick, R. P., Farrell, M., Hall, W., Degenhardt, L. (2014). A systematic review and meta-analysis of naltrexone implants for the treatment of opioid dependence. Drug Alcohol Rev., 33(2), 115-28.
- Hulse, G., O’Neil, G. (2002). Using naltrexone implants in the management of the pregnant heroin user. Aust N Z J Obstet Gynaecol., 42(5), 569-73.
- Farid, W. O., Lawrence, A. J., Krstew, E. V., Tait, R. J., Hulse, G. K., Dunlop, S. A. (2012). Maternally administered sustained-release naltrexone in rats affects offspring neurochemistry and behavior in adulthood. PLoSOne, 7(12).
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