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The opiate receptor antagonist naltrexone reduces heroin use in narcotic-dependent patients, but its real-life usefulness is limited because patients frequently stop taking the medication. This double-blind, randomized, double–placebo-controlled, 6-month Australian study examined serum levels with, and clinical response to, oral naltrexone or a surgically implanted sustained-release form of naltrexone; the government-funded study received no support from the manufacturer.
After outpatient detoxification, 70 heroin-dependent subjects received either placebo implants plus oral naltrexone (50 mg/day) or active implants (2.3 g) plus placebo pill. Blood naltrexone levels were maintained at presumably therapeutic levels (≥1 or ≥2 ng/mL) for signif…