NALTREXONE PELLET MAINTENANCE THERAPY

A pure narcotic antagonist (naltrexone) is inserted under the skin of the patient. Detoxification and naltrexone maintenance therapy is not a cure for addiction. Naltrexone maintenance therapy is a crutch to be used in early recovery. The maintenance of abstinence is best achieved through participation in a 12-step recovery program. Studies have shown that the best indicator of long-term recovery is continued participation in a 12-step recovery program. The period of abstinence during which naltrexone is used leads to a loss of tolerance to the effects of opiates. A patient utilizing naltrexone needs to be aware that when the naltrexone pellet wears off and there is a return to using the same dose of opiates that he had previously used, the patient may kill himself.

After an area is anesthetized with 2% Lidocaine with epinephrine, it is prepared and draped in the usual manner. An incision is made with a #15 blade, approximately one-half inch in length. A pocket is created in the area adjacent to the incision by blunt dissection with blunt curved Metzenbaum scissors. A 1-gram naltrexone pellet is inserted into the pocket and the wound is closed with 2 simple interrupted sutures of #3-0 Vicryl and the wound is dressed.

Should the patient be injured after the procedure and require analgesia (pain medications), he must inform the doctor that he is on naltrexone maintenance therapy so that the proper medications may be prescribed. Because the patient may be involved in an accident or some other occurrence that renders him unable to inform the doctor that he is on the medication, it is recommended that he wear a Medic-Alert tag which advises the doctor that the patient is receiving naltrexone maintenance therapy. Patients are provided with such a tag (either a bracelet or a necklace) which have on it the name of the medication and the prescribing physicians name and phone number.

The patient must be aware that following implantation of the pellet, the following symptoms might signify wound infection: Tenderness, redness, swelling and warmth at the site of the insertion of the naltrexone. If the patient notices the development of these changes, contact the physician's office so that a prescription for an antibiotic may be called in to the pharmacist.