Withdrawal syndrome caused by naltrexone in opioid abusers
H Hassanian-Moghaddam1, S Afzali2, A Pooya3
1Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Loghman-Hakim Poison Hospital, Tehran, Iran Hassanian@sbmu.ac.ir.
Human & Experimental Toxicology
|May 22, 2013
Summary
Naltrexone can cause severe opioid withdrawal symptoms, particularly agitation, in opioid-dependent patients. Emergency physicians must be prepared for this hyperacute withdrawal and its management.
Area of Science:
- Pharmacology
- Toxicology
- Emergency Medicine
Background:
- Naltrexone is an opioid receptor antagonist that blocks opioid effects.
- In opioid-dependent individuals, naltrexone can precipitate severe withdrawal symptoms.
Purpose of the Study:
- To assess symptoms and outcomes in patients experiencing naltrexone-induced withdrawal.
- To evaluate the relationship between naltrexone dose, opioid dependence, and clinical outcomes.
Main Methods:
- Cross-sectional study of 132 patients referred to a poison hospital.
- Assessment of symptoms, signs, and clinical outcomes following accidental or deliberate naltrexone use.
Main Results:
- Agitation was the most frequent symptom (96.2%), followed by altered consciousness, nausea, and vomiting.
- No dose-dependent relationship was found for most symptoms, except agitation.
- Patient outcomes were linked to the substance of addiction, not naltrexone dose.
Conclusions:
- Emergency physicians should anticipate and manage naltrexone-precipitated hyperacute withdrawal, especially severe agitation.
- Opioid-dependent patients should be advised against naltrexone misuse and encouraged to seek professional guidance for abstinence.
Keywords:
Naltrexonedrug interactionsheroinnarcotic antagonistsnarcoticssubstance withdrawal syndromeMore Related Videos
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