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June 17, 1998

Rapid Opioid Detoxification

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(23):1871-1872. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-23-jbk0617

To the Editor.—A new, promising role for opiate detoxification under anesthesia1 may be to promote initiation of long-term opiate antagonist therapy with a depot naltrexone preparation. Because of generally poor compliance, daily oral naltrexone has not fulfilled its pharmacological potential for relapse prevention in opiate dependence. Until recently, no depot preparation was available for clinical use. Since March 1997, 1 of us (C.B.) has offered selected patients a 1-g subcutaneous naltrexone implant (Wedgewood Pharmacy, Sewell, NJ). We report the results of a fentanyl challenge test to determine whether the naltrexone implant would block the opioid doses typically found in intravenous street heroin.