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- What is Naltrexone Therapy and why is
it important?
We believe that the ultimate goal of
any detoxification program is to have patients on Naltrexone.
Naltrexone is a pure narcotic antagonist. That is, it attaches
to the endorphin or opiate receptors in the brain and completely
blocks them. This means that if someone tries to use any kind
of opiate while they are on Naltrexone, they feel no effect
because all of the receptors are completely blocked. While Naltrexone
is in the body, it is virtually impossible to relapse. Naltrexone
has been available as an oral tablet since the late 1970s. However,
it only has duration of action of around 24 to 48 hours and
in practice, it has been found that most patients either forget
or purposefully choose not to take their medicine. Then in a
short period of time they go back to using Heroin. Higher success
rates have been achieved when patients are forced to take their
medicine, either by concerned family members, or by a court
system such as probation or parole. For this reason, we strongly
recommend the Naltrexone implant. We believe that Naltrexone
therapy should be given for 12 months. This gives the patient
a chance to have their brain physically recover from the damage
from the narcotics. It also gives the patient an excellent chance
to begin on the road to recovery.
- What is the Naltrexone implant?
This is a special formulation of Naltrexone,
which is designed to release slowly over a 6-10 week period.
It is placed under the patient's skin and so it is effective
and does not allow the patient to forget or skip their medicine.
We highly recommend it because it is so effective. There are
some potential side effects with the Naltrexone Implant including
infection, irritation or inflammation and sometimes even some
skin breakdown over the implant site. A licensed pharmacist
in New Jersey manufactures the implant for us. While the Naltrexone
implant has not yet been submitted to the FDA for approval,
the medications it contains are fully approved by the FDA.
- Are there any risks and side effects?
As with any medical procedure, there
are some risks and potential problems. There are some risks
associated with the Naltrexone pellet as mentioned above. There
is some risk of taking the Naltrexone Therapy before the detoxification
is complete. If taken too early, Naltrexone will push people
into a complete withdrawal state and if the detoxification is
not completely over, then there will be some withdrawal symptoms.
If done too early, these can be severe. The timing of the Naltrexone
Therapy is discussed in detail with each patient individually.
It is to be expected that patients will feel some withdrawal
symptoms but our treatment program should minimize these.
- How long should I be on Naltrexone therapy?
We believe strongly that patients should
be on Naltrexone therapy for at least twelve months. This prevents
them from relapsing back to narcotic use and gives the patients
a chance to start making changes in their lives and building
up a support program. We highly recommend at least two Naltrexone
implants and then switching to oral Naltrexone for the balance
of 12 months.
- What happens after Naltrexone Implantation?
We believe strongly that detoxification
without appropriate follow-up and treatment is almost always
unsuccessful. Our full time counselor meets with all our patients
and their families to determine the optimum treatment program
following detoxification. We insist that all of our patients
be willing to participate in an appropriate treatment program
as part of their after- care. This should include 12-step programs
and professional therapy. We expect that all patients will identify
and begin therapy with an appropriate substance abuse treatment
facility in their area as soon as possible following the implantation.
They will also need to be involved with a physician who specializes
in substance abuse.
- What is the risk of overdosing following treatment?
Studies show that there have been patients
who have died following periods of abstinence from narcotics.
This appears to be caused by lack of tolerance following a period
of abstinence. Naltrexone is extremely good at making people
abstinent but when the Naltrexone wears off, patients have a
very low tolerance. It is extremely easy for them to use too
much Heroin or other opiates and have an overdose which can
be fatal. Patients need to understand this clearly and be extremely
careful if they do relapse back to narcotic use. In my experience,
the fatal overdoses that we are aware of have usually not happened
on the first time of using and so patients need to be very careful
for at least the first month. It is also may be possible to
overdose if the patients try to override their Naltrexone therapy.
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