Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-30T02:52:22.816Z Has data issue: false hasContentIssue false
  • English
  • Français

Retention rates in two naltrexone programmes for heroin addicts in Vitoria, Spain

Published online by Cambridge University Press:  16 April 2020

M Gutiérrez ,
J Ballesteros ,
R González-Oliveros  and
J Ruíz de Apodaka
M Gutiérrez
Affiliation:
Hospital de Santiago, Servicio de Psiquiatria, Vitoria, Spain Universidad del País Vasco, Facultad de Medicina y Odontología, Departamento de Neurociencias, Apartado 699, 48080Bilbao, Spain
J Ballesteros*
Affiliation:
Universidad del País Vasco, Facultad de Medicina y Odontología, Departamento de Neurociencias, Apartado 699, 48080Bilbao, Spain
R González-Oliveros
Affiliation:
Hospital de Santiago, Servicio de Psiquiatria, Vitoria, Spain
J Ruíz de Apodaka
Affiliation:
Servicio Vasco de Salud, Osakidetza, Spain
*
*Correspondence and reprints.
Get access

Summary

The main finding of a former Spanish multicenter study (SMS) on the effectiveness of naltrexone maintenance in heroin addicts, was the high retention rate achieved at 24 weeks of follow-up since naltrexone induction (40%). The authors claimed this rate was one of the highest ever reported in the literature for a non-selected sample of opiate addicts and discussed the possible relevance of a set of variables — like motivations and expectations due to a new treatment — on the findings. To assess the possible effects of these variables, we have compared the retention rates in two similar naltrexone programmes. The first programme (hospital sample) included 56 individuals who were also included in the SMS where they accounted for 37% of the total sample. That programme was developed formerly to the naltrexone marketing. The second sample (ambulatory sample) included 67 individuals who were recruited at least a year apart since naltrexone marketing was approved by the Spanish Health Boards. The time-lag between the beginnig of both studies was in the range of 15 to 25 months.

The subjects in both programmes had similar distributions regarding age (p = 0.27), sex (p = 0.79), weeks on treatment after naltrexone induction (p = 0.20), and program compliance (p = 0.78). The retention rates evaluated over a period of 24 weeks were also similar (p = 0.45). The only difference appeared at 12 weeks of follow-up, showing in higher retention the hospital sample than the ambulatory sample (+23%; p < 0.05). The results are discussed according to other studies and it is concluded that findings reported in the former SMS and in this study are not unusual but compatible with recent research. Also underlined is the potential importance of naltrexone as a concomitant treatment for extinguishing high risk behaviours and the conditional stimuli associated with treatment relapse in heroin addicts.

Keywords

NaltrexoneRetention RatesOpiate AddictsFollow-up Studies
Type
Original article
Information
European Psychiatry , Volume 10 , Issue 4 , 1995 , pp. 183 - 188
Copyright
Copyright © Elsevier, Paris 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, DG. Practical statistics for medical research London: Chapman & Hall, 1991Google Scholar
American Psychiatric Association, (3rd ed.) Revised. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: American Psychiatric Association, 1987Google Scholar
Cibin, MGentile, NFerri, MGallimberti, LNaltrexone e prevenzione della ricaduta nella dipendenza da oppiacei. Minerva Psichiatr 1989; 30: 93–8Google Scholar
Dixon, WJBrown, MBEngelman, LJennrich, RI. BMDP Statistical Software Manual Berkeley: University of California Press, 1990Google Scholar
Forteza-Rei, JMestre, LSerra, JGallo, JAltés, JNuestra experiencia en 100 tratamientos con naltrexona. Adicciones 1991; 1: 83–93Google Scholar
García-Alonso, FGutierrez, MSan, L et al. A multicentre study to introduce naltrexone for opiate dependence in Spain. Drug Alcohol Depend 1989; 23: 117–21Google ScholarPubMed
García-Sevilla, JAUlibarri, IGiralt, MTAreso, POliveros, RGGutiérrez, MChronic naltrexone suppresses platelet aggregation induced by adrenaline and 5-hydroxytryptamine in former heroin addicts. J Neural Transm 1988; 73: 157–60CrossRefGoogle ScholarPubMed
Ginzburg, HMNaltrexone: its clinical utility. NIDA Treatment Research Report, US Department of Health and Human Services, 1984Google Scholar
Gonzalez, JPBrogden, RNNaltrexone. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of opioid dependence. Drugs 1988; 35: 192–213CrossRefGoogle ScholarPubMed
Kleber, HDKosten, TRNaltrexone induction: psychologic and pharmacologic strategies. J Clin Psychiatry 1984; 45: 29–38Google ScholarPubMed
López-Ibor, JJPérez de los, Cobos JCOchoa, EHernández, MTratamiento de mantenimiento de la dependencia a opiáceos en una clínica de naltrexona. Actas Luso-Esp Neurol Psiquiat 1990; 18: 296–305Google Scholar
O'Brien, CPChildress, ARMcLellan, ATTernes, JEhrman, RNUse of naltrexone to extinguish opioid-conditioned responses. J Clin Psychiatry 1984; 45: 53–6Google ScholarPubMed
Report of the National Research Council Committee on Clinical Evaluation of Narcotic Antagonists. Clinical evaluation of naltrexone treatment of opiate-dependent individuals. Arch Gen Psychiatry 1978; 35: 335–340CrossRefGoogle Scholar
Schifano, MMarra, RNaltrexone for heroin addiction: encouraging results from Italy. Int J Clin Pharmacol Ther Toxicol 1990; 28: 144–6Google ScholarPubMed
Silberfeld, MGlaser, FBUse of the life table method in determining attrition from treatment. J Stud Alcohol 1978; 39: 1582–90CrossRefGoogle ScholarPubMed
Simpson, DDSavage, LJLloyd, MRFollow-up evaluation of treatment of drug abuse during 1969 to 1972. Arch Gen Psychiatry 1979; 36: 772–80CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.