Patient response to naltrexone: issues of acceptance, treatment effects, and frequency of administration.
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Biomedical subjects
Publications and source records attributed to C Savage.
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Many heroin addicts prefer methadone maintenance treatment to 1-alpha-acetylmethadol(LAAM) because of the "rush-like" effect of methadone. Although there have been no observable differences in the safety and effectiveness of the two drugs, LAAM appears to lead to a more stable, consistent physiological state. The authors report on two patients who had ego defects characterized by severe mood swings. Both patients preferred LAAM to methadone because of its stabilizing effect and smoother action.
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A controlled, double-blind study of the comparative effectiveness of the narcotic antagonists, cyclazocine and naloxone, was undertaken in a metropolitan narcotic clinic offering an abstinence program involving urine monitoring and ancillary counseling services. Seventy male addict parolees were randomly assigned to 6-month treatment with either cyclazocine, 4 mg administered on a daily basis, or naloxone, 500-2,000 mg administered on a locally developed and researched 'contingent' basis, i.e., whenever there was indication of narcotic drug use (daily and contingent placebos were utilized to preserve the double-blind). Criteria of treatment effectiveness included narcotic drug usage, clinic attendance, length of participation in the program, disposition at 6 months, and incidence of side effects. The two subsamples of 35 individuals were similar with respect to relevant demographic characteristics. Examination of comparative effects revealed little to no significant differences between the two groups in terms of measures of program adherence, treatment outcome, and personal and social adjustment. Side effects were more prevalent among cyclazocine patients. Typically, these included moderately severe somatic effects and perceptual and cognitive disturbances.
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