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Patients with polydrug dependence are notoriously difficult to treat in real-world settings. Studies have shown that implants of naltrexone, an opioid receptor antagonist, successfully reduced drug use in heroin-dependent patients with no other coexisting drug dependence. In this government-funded study, investigators in Russia extended this work by randomizing 100 outpatients with concurrent amphetamine and heroin dependence to naltrexone or placebo implants. The naltrexone implants, which contain 1000 mg of naltrexone, block opioid effects for 8 to 10 weeks. Patients with significant comorbid psychiatric or medical conditions were excluded.
In an intent-to-treat analysis, at trial's end (10 weeks), naltrexone compared with placebo was asso…