If you are not getting benefit from methadone and buprenorphine, you can switch to another drug therapy known as Naltrexone. Naltrexone is a long-acting opioid antagonist. It helps in the reduction of opioid effects. It is available in the form of extended-release injections and oral formulation.

Treatment Goals and Patient Selection

The use of naltrexone recommended to the patients who:

In addition, the goals of treatment with naltrexone include

· For prevention of relapse in patients who have left opioids

· For blocking the effects of illicit opioids

· For reduction of cravings

· For the promotion of patient engagement in psychosocial intervention

I have seen a patient in the United States who dealt with his condition by using naltrexone. He is now enjoying the blessings of life. It is more effective in patients with multiple substance abuse. (Tiihonen et al., 2012)

Oral naltrexone

This way of administration is best suitable for the patient:

· Are highly motivated

· Have strict supervision

The reason behind this caution is that this drug can lead to non-adherence and the potential of overdose upon relapse. A report shows that oral naltrexone has a positive effect on patients as compared to placebo. (Minozzi S, Amato L, Vecchi S, Davoli M, Kirchmayer U, 2011) (Y Adi, A Juarez-Garcia, D Wang, S Jowett, E Frew, E Day, S Bayliss, T Roberts, 2007)

Extended-release injectable naltrexone

This type of therapy is recommended for patients who

· Have contraindication with methadone or buprenorphine

· Live in a drug-free environment

· Are highly motivated

· Do not want agonist therapy