Who uses it?

• Naltrexone is a drug taken by people who are dependent on alcohol, following detoxification, to assist them to remain abstinent from using alcohol.

• Naltrexone is also used following detoxification, to assist heroin dependent people to remain abstinent.

• Naltrexone is used in the detoxification treatment of people who are dependent on opioids such as heroin. This use is limited to hospital settings.

Treatment

• Naltrexone for alcohol dependent people can increase abstinence rates by 50%.

• Research shows that rapid detoxification from opioid dependence is neither quick nor painless and about 60% or more of patients undergoing rapid detoxification will relapse to heroin dependence within 6 months.

• Research evidence on the effectiveness of naltrexone maintenance is limited. Some studies suggest that approximately one third of people who commence naltrexone treatment will remain in treatment and are abstinent from illicit opioids at six months follow-up. Naltrexone appears to be an effective pharmacotherapy in opioid relapse prevention for well motivated, stable patients.

• The use of naltrexone anaesthesia to achieve rapid detoxification is not supported by the Health Department at this point due to concerns about safety, and the paucity of evidence of effectiveness.

Services con be accessed by ringing:

• Alcohol and Drug Information Service (ADIS) -24hr hotline
  Tel. (02) 9361 8000
  Toll free. 1800 422 599

• Naltrexone detoxification and maintenance treatment for opioid dependence are available from some public health sector services, General Practitioners and private hospitals. Rapid naltrexone detoxification is mainly available through some private hospitals and is generally not available from public hospitals.

What is NSW Health doing?

• An improved Pharmacotherapy Prescribers Accreditation training course has been developed with a distance education component, and a train-the-trainer component.

• Development and distribution of clinical guidelines for naltrexone assisted rapid detoxification from opioids.

• Training of 45 medical and non-medical clinicians in detoxification units.

• Detoxification involving naltrexone is available through public detoxification units for selected patients.

• The development of clinical and operational standards for licensed private hospitals and day procedure centres.