There is a need for new opiate addiction treatment options. One approach which is potentially valuable is the narcotic antagonist, naltrexone. Although naltrexone has been demonstrated to be a safe and effective antagonist, it is infrequently used. The major complaint about naltrexone is that addicts will not take the medication for clinically significant periods of time. A number of strategies have been identified which increase the treatment retention of patients using naltrexone. These strategies have been incorporated into an outpatient treatment manual which is the Phase I product for this project. This Phase II application proposes a test of the model presented in this manual. One hundred thirty (130) detoxified opiate addicts will be randomly assigned to two treatments with naltrexone. Sixty five (65) subjects will participate in the treatment protocol described in this manual while receiving naltrexone. The other 65 subjects will receive a monthly medical visit plus attendance at self-help meetings concurrent with their naltrexone. Self-reports of drug use, ASI scores, urinalysis results, medication compliance and treatment retention and a number of rating scales will be used to compare outcomes. Successful demonstration of a model to facilitate naltrexone will offer a new treatment option for opiate addicts.
