A significant portion of individuals who are addicted to opioid painkillers may initiate and maintain abstinence with a brief but intensive outpatient detoxification treatment followed by opioid antagonist therapy using naltrexone.
Two recent studies suggest that genotyping may enable clinicians to base therapies on individual patients’ potential responsiveness to opioid drugs’ therapeutic effects and vulnerability to their harmful effects.
Intensified screening for HIV among injection drug users receiving opioid agonist therapy could prevent more than twice as many new infections as current screening practice. A recent study based on mathematical modeling found that screening every 6 months instead of annually, and adding viral RNA testing to the currently used HIV antibody testing, could improve both effectiveness and cost-effectiveness.
Microneedles are an innovative technique for delivering medications through the skin, a route that could particularly benefit patients receiving naltrexone therapy for opioid and alcohol dependence. Researchers have found a way to use the transdermal technique to deliver a single treatment of naltrexone that lasts for 7 days.
A trial of buprenorphine/naloxone (Bup/Nx) showed no evidence that the medicine was associated with liver damage. The drug gave results similar to those of methadone. The study data indicate that although most patients can be treated safely with either methadone or Bup/Nx without major concern for liver injury, clinicians are advised to continue to monitor the liver health of their patients who are on methadone or Bup/Nx therapy.
More than half of heroin-addicted patients treated with naltrexone via an implanted delivery device maintained abstinence throughout a 6-month clinical trial in Saint Petersburg, Russia. The implant device, which releases a steady dose of naltrexone continuously for 2 months, averted relapse to heroin use three times as effectively as daily oral doses of the medication.
Dr. Marilyn Huestis of NIDA’s Intramural Research Program talks about conducting research on drug effects with human subjects, developing tests to help law enforcement identify drugged drivers, and an assay to help identify children whose prenatal exposure to anti-HIV drugs may put them at risk for adverse developmental outcomes.