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Narcotic antagonist drug treatment

   Like many chronic diseases, heroin addiction is a complex condition to treat, involving both individual aspects, physical and psychological and also with high impact on the social enviroment. That’s why the effectiveness of a narcotic antagonist drug treatment should be measured equally in terms of its impact on crime rate or prevalence of heroin addiction and success in the treatment of afflicted individuals.

   The ultimate goal of treatment for heroin-dependent persons should be patient's control over the use of that drug. Along with heroin addicted individuals, there are those ones who have never been dependent on heroin but are using the drug and, therefore, are at risk of becoming dependent, especially because currently available treatments for them are limited and they are still unable to resist giving in to the intense craving for heroin. This is the main reason for the development of narcotic antagonist treatment.

   Narcotic antagonists are usually defined as chemical compounds which block the effects of opiate drugs. Narcotic antagonists will block the analgesia, the euphoria and all-the physiologic changes such as pupilary constriction produced by agonist opiates. By blocking the effects of agonist opiates, narcotic antagonists also prevent the development of physical dependence and tolerance to opiate drugs.

Opiate drugs exist on a continuum with morphine, heroin and other agonists at one end and antagonists such as naloxone and naltrexone at the other end. There are many well-known drugs which fall between pure agonists, such as heroin and morphine, and pure antagonists, such as naloxone and naltrexone. Naltrexone is a potent narcotic antagonist. It has a long duration of action, up to three days following one oral dose. It is devoid of agonist activity and thus the induction phase is virtually asymptomatic. Using Naltrexone for opiate addicts usually is conducted in outpatient facilties although initiation of medication often begins after medical detoxification in a residential setting.

Naltrexone is administered orally either in liquid or solid (capsule) form. The capsule is preferable, because naltrexone has an extremely bitter taste, even though the liquid formulation is esier to be ingested by subjects. The frequency of administration is either daily or three times a week. Patients who are currently physically dependent on an opioid drug must first be detoxified before they can be put on naltrexone. The selection of a method of detoxification is always made by the clinician, considering the fact that the clinic facility where patients are treated with naltrexone is critical to the treatment's success. The fact is that naltrexone is not a treatment in itself, but a pharmacologic adjunct to treatment.

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