FAQ ABOUT NALTREXONE THERAPY (NALTREXONE PELLET/HEROIN BLOCKER)
Questions and Answers on Naltrexone blockers (anti-heroin chip)
What is Naltrexone therapy and why is it important?
Naltrexone is the total opioid antagonist. That is, it attaches to the opiate receptors in the brain and completely blocks them. This means that if someone tries to use any kind of opiate drugs while being on Naltrexone, they feel no effect because all of the receptors are completely blocked. Naltrexone has been available as an oral tablet since the late 1970s. However, it only works for around 24 to 48 hours and in practice, it's been recorded that most patients either forget or purposefully choose not to take their medicine. Afterwards they go back using heroin in just a short period of time. Higher success rates have been achieved when patients are forced to take their medicine, either by concerned family members, or by a court system such as probation or parole. For this reason, we strongly recommend Naltrexone implant. We believe that Naltrexone therapy should be maintained for at least 12 months. This gives ex drugs users time to allow their brain's rewarding system recover from the damage inflicted by the drug abuse. It also provides an excellent opportunity to make significant changes to one's lifestyle.
What is a substitution therapy?
An opiate substitution programme is based upon legal opiate drugs (like methadone (heptanon), buprenorphine (subutex, suboxone), morphine-sulphate (substitol, compensan), and medical heroin). Intake, is conducted under medical supervision, as a part of heroin addiction treatment program. Such patients continue taking legal opioids (synthetic opiates), trying to lower their daily intake, doing their best to have a regular job and to adapt to a normal social life, whilst still remaining drugs users. Unfortunately, the opiate tolerance is maintained and an addicted person is often forced to top up with heroin, sedatives or some other substances. Then, the addiction becomes even more complicated. Getting clean from methadone is much more difficult than giving up heroin. Opiate substitution therapy is not an addiction treatment. It is purely an attempt at harm reduction being made for the benefit of both the addicted people and society by preventing the illegal abuse of drugs.
What is the difference between methadone or other opioid substitution therapy and Naltrexone maintenance therapy?
The difference is simple: you choose whether to take drugs all your life (legal or not) or to protect your abstinence by the use of Naltrexone maintenance. You can then learn how to enjoy a drug free, healthy life. It's up to you. When you choose to opt for comfortable abstinence, we are here to help you.
Are there any unwanted side effects of Naltrexone?
Just like any other medication, Naltrexone has some unwanted side effects. We've noticed tiredness, weakness and dizziness in 3% of patients. Some patients reported abdominal discomfort and feeling slightly down. Fortunately, these symptoms last less than one day. Therefore, we recommend taking some rest during the first day of the Naltrexone maintenance and to contact your GP if side effects occur.
How does Naltrexone protect from relapse?
Naltrexone (or 'heroin blocker') is a narcotic antagonist; it blocks the effects of heroin (as well as any other opiate like Methadone or Suboxone) by blocking the opiate receptors within the brain. It works by binding to some of the drug receptors in one's brain, thereby preventing opiates from attaching. If opiates are taken, they simply will have no effect and therefore are a waste of money. In that way, relapse prevention is provided. You will have more confidence and experience fewer cravings such as those suffered during the unprotected abstinence.
When can Naltrexone induction be started?
Immediately after the tests have confirmed that the body is 100% drug free. It means that there will not be any withdrawal reaction to Naltrexone implant or Naltrexone injection. Everything will go smoothly. Naltrexone maintenance may start on the 7th day after the last heroin intake or on the 10th day after the last methadone intake.
What unwanted reactions to Naltrexone can be expected? Can they be avoided?
If a person didn't receive a qualified opioid detoxification and if the necessary drug tests weren't taken, or if the body was not thoroughly cleansed from drugs, then uncomfortable withdrawal symptoms may occur.
Are there any potential risks and side effects related to the Naltrexone implant?
There are some potential side effects (less than 8%) with the Naltrexone implant including infection, irritation or inflammation and sometimes even some skin breakdown over the implant site. Luckily, these reactions are very easy to eliminate by the use of antihistamine and anti-inflammatory therapy. By using a highly qualified and accurate nurse, possible complications can be avoided.
Are there any risks and side effects after the Naltrexone injection administration? How can they be avoided?
Naltrexone injection or Vivitrol might cause allergy in extremely rare cases. An immediate anti-allergic therapy neutralizes the allergic reaction.As long as a professional medical nurse administers the intramuscular opioid blocker injection, possible infection can be avoided.
What happens if one takes opiate drugs during their Naltrexone maintenance period?
The body's reaction depends on the opiate drug type, dosage, and individual receptors' sensitivity at that very moment of his abstinence etc. A patient might not feel any effect from the drug or may feel very weak sensations. Worst case scenario, he may suffer an overdose with a high risk to his life.
Some addicts report that it's possible to override Naltrexone blocker. Is that possible?
Drug users, especially drug dealers share among themselves ways to override the Naltrexone implant. Some study chemistry, pharmacology while others experiment, organize betting and competitions in who'll be the quickest to override an implant. The survivors brag and spread their ways of fighting against the Naltrexone implant on the internet. It is possible to ruin any kind of treatment and to end an abstinence if one wants to strongly enough. It can be done at high risk to life. These people present themselves afterwards as heroes or victims. It leaves only one question to be answered: why did they ask for Naltrexone implant at all? Naltrexone pellets are designed to protect opiate receptors from occasional accidental drugs intake, making the addict unreceptive to opiate effect, and heroin intake and similar situation senseless. Naltrexone implants are not designed for systematical fight against of Naltrexone blockade, repeated and persistent attempts to override, melt, use up or neutralize its affects.
How do addicts fight their Naltrexone implants?
We are not going to advertise all the ways that this can be done in order to avoid inspiring new lion hearts. We are only going to say that some don't follow the recommendations to prevent infectious and allergic reactions. Others deliberately infect an implant site; even burning it with an iron and suggest that to their fellowships. The most experienced use different pharmacological tricks. The question is, wouldn't it would be much smarter to just ask a doctor to remove the Naltrexone implant?
How can one avoid such risky games with an implant and avoid complications and even death?
Patients should be informed about Naltrexone maintenance . One should not reinforce the myth about Naltrexone being the ideal and final solution:"Take an implant and forget about heroin". This is just not true as there is no final solution to drug addiction. No one has won a Nobel Prize for saving humanity from heroin addiction. There are no guarantees on Naltrexone treatment. Research and development continues as we speak. Naltrexone implants are purely the best method amongst dozens of others.
When would be better to say goodbye to a Naltrexone implant and have it removed?
An implant is meant for protection of opiate relapse when one accidentally takes opiate drugs. The implant is not meant for protection of deliberate attempts of override the opiate receptors blockade and repeatedly opiate drugs intake. When a patient repeatedly takes opiates while putting their life at risk while having an active Naltrexone blockade till they override Naltrexone protection, it can mean only one: that a patient was fully aware to have dropped out of the Naltrexone maintenance program. To avoid deadly risks, it was only required to inform their Naltrexone specialist about their intentions and make an appointment for removing the implant.
What to do if one is not convinced of their blocker? How to test it?
If one doubts the effectiveness of their Naltrexone blocker, or is convinced that the implant is not releasing Naltrexone in their body, it is necessary to contact their Naltrexone specialist and have diagnostic procedures to control the activity and the condition of the implant. In any way it is possible to add additional Naltrexone protection and put one's mind at ease.
Are there any signs pointing to a possibility that a patient considers seizing their abstinence and go back to drugs?
Yes, of course. An abstinent refuses to follow the medical recommendations and conditions of Naltrexone treatment. For example, they "forget" to take follow up medications, don't fulfill the sterile conditions of the wound dressing change. consumes alcohol, puts a physical pressure on the implant site. If one stops sending regular reports about their Naltrexone maintenance, it often means that motivation and maintaining of the abstinence had decreased and soon enough cravings to use drugs will occur.
- Can Naltrexone help for alcohol dependence?
- Yes, it can decrease alcohol effects and cravings, helping in alcohol abuse problems. Naltrexone is successfuly used for that in many countries for years. Depot Naltrexone formula "VIVITROL" is recommended for alcoholism treatment by FDA. However, it does not block alcohol effects directly and it is not absolutely useful for all people. Some patients reported Naltrexone did not decrease alcohol effects significantly. And some told, that it was really helpful initially, but couple of months later it becomes useless. It seems, that a body can adapt to Naltrexone blockade if alcohol consumption remains regular.
What is the risk of overdose following the Naltrexone maintenance period?
Studies show that there have been patients who have died after the periods of abstinence from drugs. This appears to be caused by lack of tolerance following a period of abstinence. Naltrexone is extremely good at helping addicts stay away from drugs, but when the Naltrexone wears off, patients have a very low tolerance to opioids. It is extremely easy for them to use too much heroin or other opiates and have an overdose which can be fatal. Patients need to understand this clearly and be extremely careful if they do relapse back to drug use. It is also may be possible to overdose if one tries to override their Naltrexone therapy.
What should I do if cravings develop?
If cravings appear (usually after being in contact with addicts, dealers and other provocative situations), followed by emotional tension, restlessness and the urge to use drugs, then very often the only solution is the strengthening of the Naltrexone blockade by having additional implant or a Depot Naltrexone injection. This is usually enough to help a person to calm dawn and relax and to return to the rehabilitation process. In some other cases, an anti-cravings program might be required.
How long should a patient be on Naltrexone therapy?
Does Naltrexone implant stay under the skin after its opiate blocking effect is over?
Yes, often it takes longer for the rest of the pellet to dissolve up to several weeks. Sometimes the implant "disappears" before the preset time. Many factors can influence this: inflammation, violation of fibrous capsule formation around the implant in the subcutaneous tissues, of the implant site, accelerated metabolization of the biodegredible polymer enzyme systems of the patient, splitting into small fragments, pellets, increased friction surrounding tissue due to the strong muscle contractions and etc. Some patients start fighting the implant, some even confessed trying to heat it up with hair dryer, or to melt it with hottie. Others reported crushing the implant in their body. The smart ones have just asked a surgeon to remove it. None know the truth about this, but we can help once again should a patient becomes responsible and corrects their strategy by returning to the Naltrexone maintenance
What kind of recommendations must be followed after the Naltrexone chip insertion?
1. To visit a medical facility for a regular wound dressing and surgical check ups
2. Keep your dressing clean and dry. Do NOT soak in a bath/tub. If you shower, you must cover the wound with plastic to keep dry.
3. Avoid intense physical activity and sports involving the muscles around the implant, do not to carry or lift more then 10 kilos and don't drink alcohol for at least 4 weeks after the implantation
4. To take the stitches out on time (normally on the day 7 after intervention)
5. To visit a doctor and to contact us immediately via firstname.lastname@example.org in the case there is slightest doubt about possible complications, Naltrexone processes or any other issues associated to Naltrexone treatment.
Does implant work exactly for how long it is meant to work?
Neither the implant, nor your body has a timer. With some it may work somewhat shorter, with others longer. We use 2500 mg Depot Naltrexone pellets (active up to 7,5 months in some patients) for the 6 months Naltrexone maintenance program. And 5000 mg pellets (active up to 13 months) for the year long program. Still, it is noticed that if you have renewed implants (second, third, fourth etc.) your liver learns to metabolite Naltrexone quicker. In these cases, Naltrexone concentration in blood decreases. Therefore, no one can guarantee an exact period of time of the working of the implant.
Does Naltrexone affect liver?
Several studies have shown that the rate of ALT elevations during naltrexone therapy is similar to that with placebo. Most serum aminotransferase elevations during naltrexone therapy are mild and self limiting, resolving even with continuation of therapy.