There is a need in the commercial system for new opiate addiction treatment options. One approach which has long been considered a potentially valuable strategy for this purpose has been the use of the narcotic antagonist, naltrexone. Naltrexone is an antagonist which has few side effects and blocks the effects of opiates without producing euphoria or dependence. Although naltrexone has been demonstrated to be safe and pharmacologically very effective, it is infrequently used by most commercial addiction treatment organizations. The major complaint about naltrexone is that addicts will not use the medication for clinically significant periods of time. A number of investigators have identified strategies which increase the treatment retention of patients using naltrexone. The purpose of this project is to produce a manual which will provide a psychosocial support program to maximize the retention of patients in treatment with naltrexone. This manual would have commercial value as a protocol to be disseminated to commercial organizations to promote their effective use of naltrexone. A phase 2 portion of this project would empirically evaluate the protocol described in the manual in a controlled clinical trial with random assignment.
