Naltrexone Implant Costs

1. Naltrexone is a pharmacological antagonist of opiates. It makes impossible to take opioids. Today it is the most effective pharmacological agent against heroin, methadone, Oxycontin, Tramadol, Substitol.
2. The fact is that prolonged use of naltrexone recovers the activity of opioidergic systems in human brain. This means that during the time the deficit of pleasant emotions is reduced, a patient has a feeling that something is missing and this kind of feeling disable many patients to forget about drugs.
3. Protection of Naltrexone helps patients to keep social activity. The patient can work freely, be with his family, travel. There is no need to hide from drugs in closed Rehab centre.
4. Protection of Naltrexone can be long and effective. Last generation implants provide a stable concentration of Naltrexone during 2, 3, 6 and 12 months period.
5. Naltrexone has also shown its effectiveness in alcohol addiction treatment, stimulant drug addiction, gambling.

If patient doesn`t have contraindications and the treatment strategy does not include a substitution therapy, every kind of pharmacotherapy includes the use of Naltrexone. This is the gold standard worldwide. Implants help patients not to have problems of cooperation with a doctor and not to terminate the therapy prematurely.

A study at the University of Western Australia has found that heroin addicts with naltrexone implants are far less likely to return to heroin use than those taking oral tablets.

But critics are sceptical about the study and say that naltrexone is still a risky option for drug users trying to kick the habit.
Naltrexone is a drug which blocks the effects of heroin on the brain. It is usually taken as a tablet, but if heroin users stop taking the pill they often fall back into drug use.
That is why scientists have been working on an implant which automatically releases naltrexone into the body.
Gary Hulse from the University Of Western Australia is confident about the naltrexone’s success.
“It means that you’ve got a a one-stop shop. People can come in, they receive their treatment or implant and for five months or six months, they carry that treatment with them,” he said.
The six-month trial involved 69 heroin users. Fifty-four completed the trial. Of the 28 participants who received a naltrexone tablet, 15 returned to regular heroin use. Of the 26 people who received a naltrexone implant, just two returned to heroin use.
Researchers like Mr Hulse say it is a good result for naltrexone implants.
“This is a relatively safe and a treatment which has good clinical outcomes,” he said.
The study is yet to be published in a peer-reviewed medical journal, but the team at the University of Western Australia are confident the research will be well received.
“I’m not only confident that it’ll be published in a peer review but I would be surprised if this wasn’t accepted by one of the extremely high rating journals,” said Mr Hulse.
But critics like Dr Alex Wodak, from the Alcohol And Drug Services at Vincents Hospital in Sydney, have little time for the new study.
“The paper hasn’t been published yet in a scientific journal and so therefore, it’s the equivalent of hearsay in a court of law. That is, it’s not really evidence,” he said.
Naltrexone is a controversial drug. The implants are yet to be approved by Australia’s Therapeutic Goods Administration (TGA) and there have been mixed results for heroin users.
Some patients have stopped using heroin after receiving an implant. But others have cut them out of their body or suffered serious side effects.
“The implants, I know for a fact, were at one stage required by the therapeutic goods administration to be stamped, not for use in human subjects, and the authors have conceded that to me in writing,” said Dr Wodak.
But researchers such as Moira Sim from the Naltrexone Trial Independent Monitoring Committee say the implants used in the Perth trial were approved by the TGA.
“The committee reviewed all the processes that the trial went through and we are confident that they followed the correct processes that the data was collected properly, and therefore I’m very confident in the results of the trial,” she said.
The researchers say the next step will be to conduct a trial comparing naltrexone implants with methadone and other drugs used to control heroin addiction.
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source: ABC News, http://www.abc.net.au

One Response to “New hope for heroin users: Naltrexone implants.”
1. Dr George O’Neil Says:
December 29th, 2008 at 7:37 am
Naltreone is a drug that always works efficiently providing the medication has been taken or delivered effectively. The problem for heroin addicts and for those with other addictions that may respond to naltrexone treatment is one of making sure that the drug is delivered. In Perth we have treated 2,300 patients for opiate dependance, 230 for alcohol dependance and 230 for amphetamine dependance with naltrexone implants. The randomised study by the university of Western Australia talked about above is the first RCT with an implant delevering naltrexone at theraputic levels for 4-6 months. The comment that naltrexone is a contraversial drug is out of context with a thorough research program on naltrexone since 1964. Providing the drug is delivered properly at appropriate concentrations it always blocks the opiate receptors. The development work in Perth to allow more efficient delivery of naltrexone opens up a method which shortens the number of years of opiate dependance and protects against overdose for prolonged periods of time. We have had no overdose deaths in the first 9 months following treatment in approximately 4000 patient years of treatment. We will continue to work to improve this area of medicine and we are confident that the randomised controlled trials of long acting naltrexone described above will help. In the past we have been limited to using opiate agonists (eg methadone) as the safest method of managing opiate dependance. Long acting naltrexone implants specifically control the opiate dependance for long periods of time (4-10months) without maintaining and therefore prolonging the opiate dependance that the patient wanted treatment for. In Australia and Scotland we have large groups of patients who are now dependant on their opiate replacement medication who wish to become independant of their opiate dependance. There should be no contraversy in the fact that treatments like naltrexone implants offer an excelent replacement to methadone and other opiate medications for these patients now wanting to cease their prescribed and non prescribed opiates. As doctors get more experience with these new medications comments on contraversy will disappear. There is no doubt in my mind having managed more than 4000 naltrexone implant treatments that naltrexone implants will become as important as methadone in treating heroin addicts who wish to escape from opiate dependance. In the mean time we all need to do our medicine as well as we possibly can and avoid regarding naltrexone or methadone as contraversial. Both have been delivered in good programs to patients requesting medical assistance and have been incredibly useful to those patients.It is essential for all in the field to use the medications available as well as we can.
Dr George O’Neil

Drug addiction is a complex multifactorial disease. Regular long -term drug abuse undoubtedly results in deleterious changes in chemical and neurophysiological status of human brain.
These changes explain such features of addiction as growing tolerance ( need to increase dose of the drug continuously to achieve the desirable effect), syndrome of altered reactivity ( when over the time the action of the drug becomes inconsistent and unpredictable) syndrome of physical and psychological dependence (inability of the body to function normally at the absence of the drug).
Drugs severely deform body, mind and personality of a drug user. It looks as follows.
Soon after start using the dug systematically dramatic transformations in mind and body of a drug user happen. These changes are familiar to every addict. They reflect a shape of a new system functioning. All physiological, biological and psychological processes in a drug user body are getting subjected to the drug. Without presence of narcotic people can not eat, sleep, sex, work normally. The absence of the drug (so called “drug hunger”) is perceived by the body as a stress and all efforts, actions of a drug addict are concentrated on the search of a substance to eliminate its deficit. After consuming the dope the “drug hunger” subsides for a while, and the person is able to stay for few hours in «normal» state. Again he/her becomes able to eat, to sleep, may be even to have sex, or to be focused on doing something. But most likely that all these “normal things”, daily responsibilities, duties are no longer so important for him. The poor often is just resting before the internal alarm will turn on again indicating the fall of drug concentration..
Distorted metabolism, taste deviations, digestion problems, depressed immunity, broken teeth, poor skin, internal organs disorders are all the physical sings of a disease.
Besides, there are profound changes in mental condition. One of the first signs of mental instability presented of all drug addicts is a symptom of sleep disturbance. Normal biological rhythms of the brain are violated by the drug. Structure, duration and quality of sleep are distorted and, as a result, the brain is unable to properly rest, to relax. The patients on high doses of the drug are quite aware of the situation when they take a dose in advance in hope to have a proper sleep, but still they wake up earlier broken and frustrated. Anxiety, impulsivity, outbursts of aggression and periods of depression, suicides thoughts are the result of drug interference into sphere of emotions.
Well, the third component of clinical picture of drug addiction is psychological. Diminished life value system and weakened inner rules of self-control are common signs. The drug addict stops planning his life for long period, he lives only by current day. Necessity of constant search for the drug makes him dodge, deceitful, manipulative. No one better than a drug addict is able to induce compassion and pity for him. Quick mental fatigue does not let him to get focused at work. He becomes tired quickly, idle. Every moment he is trying to find any excuses to avoid his professional and domestic responsibilities. Emotional degradation, coarsening leads him to regular conflicts within family. Eventually the drug addict becomes an outcast.
Lack of survival instinct, reduced internal “safe-keeping ” mechanisms, underestimation of the situation, low support from family are the factors which inevitably lead the drug addict to social degradation and isolation, to continuous conflicts with a law, to numerous concomitant diseases, to frequent accidents and overdoses which often end up in death.

So how can we stop this agony?
Who or what can help us to find the right solution, to find the way out of this deadly situation? Naltrexone? Methadone? Buprenorphine? Or may be the Lord?
There is a solution.
First of all you have to know that drug addiction is a curable disease. And there are plenty of examples for that claim. It is not rare when a seemingly washed-up drug addict after 10-15-20 years of continuous drug abuse with help of properly selected treatment stops using drugs and never comes back to them. These facts suggest that the DRUG FREE LIFE is possible at any stage of addiction, and there are no biological constraints to abstain narcotics for good.
In order to obtain positive long-term reliable result, but not just another disappointment, you have to start with a plan and proper organization of your future recovery . Before enter the treatment you have to understand clear that no one alone is able to pull himself out of the mire of a drug addiction. All your knowledge of pharmacotherapy, the best advices of your experienced friends or attempts to go somewhere for couple of weeks to undergo “cold turkey” can bring only a temporary relief at best.
What you have to do first is to inform your relatives or people close to you about your firm intention to kick off the drugs. These people are your main support. Then you have to see a specialist in addiction medicine to assess the situation and elaborate an individual treatment plan.
As it was said before drug addiction is a multifactorial disease. Therefore treatment must be comprehensive.
The process of recovery consists of several sequent stages. The first one is detoxification. The task of detoxification is to cleanse the body out of the drugs and let the patient to pass through withdrawal (set of symptoms which characterize physical dependence) in a most painless way. Due to its complexity, good quality drug detox can be done only under qualified medical supervision. Detoxification is a preliminary and mandatory stage. It is half the battle for successful recovery.

Special treatment techniques and psychological rehabilitation programs are needed to cure such mental dysfunctions featured psychological dependence as craving, depression, mood swings, sleeping disorders.
Quite often pharmacological protection ( blockade) by opiate antagonists alone or in combination with a long -term isolation provides the most effective cure for many patients.
Professional help from the specialists in addiction medicine, psychologists, psychotherapists, group therapy, family support are the key factors to help the drug addicts to change their habits, lifestyle, the regain their ability to resist to their seemingly irresistible compulsion for drugs.
Without accomplishment of all these obligatory conditions the chance to come off the drugs looks very unlikely.

How naltrexone can help?
Naltrexone is an opioid antagonist. Due to it nature it blocks the opiate receptors and by this way prohibits the use of drugs. In other words it is antinarcotic. Naltrexone is be a good support for motivated patients. . Naltrexone program is a highly promising pharmacological rehabilitation for endogenous opioid structures of human brain. At the moment Naltrexone is the best pharmacological protection against drugs.
Naltrexone has also been shown effective in managment for alcoholism, gambling and some other types of behavioral addictions. This universal property of Naltrexone indicates its ability to interfere into underlying mechanisms that are common to all types of addiction.
Naltrexone implants are the most effective form of therapy by opiod antagonists nowadays . Implanted pellet ensuring a continuous level of Naltrexone in a body for long period is a method of choice for the patients who have a problem with treatment compliance.
Emerged since the early 90s the implants have significantly improved and now so-called third generation of implants is available. They are characterized by better consistent release of depot naltrexone, by higher level of protection and by lower frequency of rejections and allergic reactions. The use of polymer matrices has allowed to create implants that work up to 6 and 12 months. Implants are currently produced in the U.S., Hong Kong, UK, Australia, Holland, Japan. In the U.S. The use of depot injection of naltrexone «VIVITROL» is officially approved by FDA. The use of naltrexone implants, issued patents, is possible through the passage of a special application procedure. In Russia Naltrexon 3 -month implant is officially approved for use and available under the trademark “Prodetoxon. In Australia more than 10,000 people received implant treatment over the past 5 years.