Naltrexone in drug addiction: significance in the prevention of relapse.

The primary aim of this study was to investigate significance of the naltrexone in the management of drug addiction. A total of 108 opiate dependent drug abusers were included in this study. The study period was May 2004 to March 2008. They were selected consecutively on the basis of defined criteria. Of 108 drug abusers, 81.48% were literate and rest was illiterate. In current profession, majority of them (81.48%) had no work; rests were businessmen (13.89%) or service holders (4.63%). Nearly 72.22% drug abusers were young adult had age 20-30 years and 71.30% were married. About 94.00% of them were using heroin. In lifetime, sixty percent of them had been using heroin or phensedyl for 3-5 years, 25.93% for 6-10 years and 13.89% for 11-16 years. Hundred percent of the studied drug abusers had habit of smoking cigarettes. Most of them were heterosexual having sex with multiple partners. Nocturnal insomnia, difficulty falling asleep or hypersomnia, antisocial and/or irritable behaviors were found among them. About 75.00% of them had altered food habit and 45.37% had sexual dysfunction. Eighty-four percent wives of the participant drug abusers were found to be literate and 84.42% had only household works in their profession. Illiteracy was found to be higher in mother (26.85%) than that of father (24.07%). Majority of the father were found to be businessmen and mothers had household works only. Their family income was Tk.10,000-20,000 monthly. In addition, disharmony among family members, illicit drug users and mental illness were found in 81.48%, 23.15% and 21.30% families respectively. About 95.00% of the participant drug abusers were completed treatment schedule with naltrexone successfully and rest were dropout. Only 45.37% of them were developed adverse effects; of which, insomnia, nausea vomiting, headache, abdominal cramps and nervousness were found to be notable. Finally, 75.93% participant drug abusers were relapsed and rest (25.49%) was remained abstinent from illicit drug use. Multiple factors were found to be liable to use illicit drugs once more. Of them, unpleasant emotional state, sexual dysfunction, friend's incitement, family disharmony and interpersonal conflict were found to be crucial important. All of the participants were acknowledged essentiality of the Naltrexone in the treatment of drug addiction. They expressed their satisfaction during treatment including abstinent period. Most of them had not physical or mental craving for illicit drugs as before treatment and did not mention sleep disturbance or other mental troubles. They had normal food habit, increased appetite and taste preference in abstinent period. However, naltrexone could play important role in demand reduction but has no effect to enhance self-efficacy. In combination with self-efficacy enhancement therapies, it would be effective in the treatment of opioids dependence.