Naltrexone implant therapy can be started only after completion of detoxification from drug and definite absence of withdrawal syndrome.
Don’t try to take naltrexone if you used opioids during the seven to ten days before – even taking a small dose it provokes crisis and you won’t be able to relieve it by taking another dose of dope. This painful, distressing condition is very dangerous for your health.
1. Opioids have not been taken for a definite period of time. (It’s not just for heroin but for all substances, which have been used to facilitate going through a withdrawal: methadone, buprenorphine, tramadol, codeine, nalbuphine, butorphanol, etc.)
2. A rapid test for the presence of residues of opioids in urine has made. You can contact your doctor for the next step then.
3. A doctor considers such essential factors as physical condition of the patient, the absence of contraindications (liver failure, pregnancy, planned surgery in the near future), the level of the patient’s motivation and availability of family members to ensure control of the naltrexone therapy. Talk to the relatives of the patient about upcoming treatment is essential. Chromatographic test for the presence of residues of drugs in urine must be repeated.
4.Test by Naloxone. Naloxone is also a blocker of opioid receptors in drug addiction treatment. Its action is similar to naltrexone. However, naloxone is considerably weaker and works only for about 30 minutes. The meaning of the test is to introduce a small amount of a short-term blocker, to be sure that it doesnt provoke abstinent syndrome. We introduce 2-4ml of naloxone i.v. or i.m. and within 20 minutes we monitor blood pressure, pulse, SaO2, pupil size, the appearance of goosebumps, sneezing, and other signs of withdrawal syndrome. If they occur – the use of naltrexone is not possible.
5. If Naloxone test is negative the patient receives 25 mg of naltrexone and stays in hospital for the next 30-45 minutes under constant monitoring in case of possibility of development of withdrawal symptoms.
6. In case of negative response to the test , the patient receives injection of Vivitrol (naltrexone-palmitate) or Naltrexone implant pellets can be implanted. After that, we recommend the patient to stay in rehabilitation clinic under the supervision another 1-2 hours.
Usually all these checks are without any complications. The meaning of a multi-stage testing is to avoid a situation when a patient, for whatever reasons, distorts information about drug use, and do not jeopardize his health.