Glutamatergic Modulation to Facilitate Naltrexone Initiation in Opioid Dependence
Status:
Completed
Trial end date:
2016-12-01
Target enrollment:
Participant gender:
Summary
Opioid dependence is a substantial problem associated with significant morbidity and
mortality. Extended-release naltrexone has been found effective at reducing opioid use and
maintaining abstinence, but its use has been limited by the difficulties encountered with
treatment initiation, which involves detoxification from opioids and oral naltrexone
titration. Improving the likelihood of a successful transition to naltrexone is therefore an
important public health goal.
N-methyl-D-aspartate receptor (NMDA) antagonism has been found to alleviate the signs and
symptoms of withdrawal from opioids, as well as to address adaptations associated with
chronic opioid use, such as opioid-induced hyperalgesia (increased pain sensitivity). These
benefits may persist for at least 72 hours after a single dose. NMDA antagonism may therefore
facilitate a rapid transition to naltrexone by reducing discomfort, improving motivation, and
ameliorating adaptations associated with drug dependence, such as craving and arousal.
The purpose of this trial is to assess the feasibility of NMDA antagonist-assisted naltrexone
initiation in opioid dependent individuals. After administration of extended-release
naltrexone, participants will be followed for 4 weeks, and transitioned to appropriate care
subsequently (oral naltrexone, extended-release naltrexone).