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Biomedical subjects

Helge Waal

Publications and source records attributed to Helge Waal.

6 recordsLinked to original sources
PubMed2003

[Naltrexone implants--a pilot project].

BACKGROUND: An increasing number of Norwegian heroin addicts have had naltrexone implants abroad without proper documentation. The authors established a joint project to study duration and safety. MATERIAL AND METHODS: Methodology to measure naltrexone in plasma was developed. 10 patients had 21 implants. Plasma samples were collected before, one and three hours after implantation, daily for one week, then weekly. Patient satisfaction, side effects and unwanted medical events were recorded. RESULTS: Patients had a protective level of naltrexone for 35-80 days. Side effects were few. Two patients had abstinence reactions caused by insufficient detoxification. Two patients had their repeat implants removed because of tissue reactions. One patient developed hepatitis C infection in the second week after implantation. One had transient increase in transaminases after heavy multi-drug use. The others were without signs of hepatic toxicity. INTERPRETATION: Use of implants secures a prolonged period of naltrexone protection. Implants are mostly well tolerated, but tissue reactions to repeat implants could be a problem. Evaluation of the patients should be thorough and the treatment integrated in a competent follow up.

Adult↗
PubMed2003

[Use of naltrexone in the treatment of young drug addicts].

BACKGROUND: The study explores the use of naltrexone as an adjuvant therapy for psychosocial treatment in a unit for young heroin addicts with frequent relapses. MATERIAL AND METHOD: Naltrexone was introduced through discussions in the therapeutic community. 16 patients elected to participate in a six-month trial. Side effects were recorded daily, then weekly, and patient reactions by weekly self-ratings. At end point patient and counsellor independently scored estimated utility. The group was followed up at four years. RESULTS AND INTERPRETATION: Staff and patients developed an increasing degree of consensus during the project. Naltrexone is a useful adjuvant therapy. Several short-term goals were reached; side effects were minimal. Four out of 16 patients completed the full six-month treatment. 11 patients judged the use of naltrexone as somewhat or very positive. Therapists judged naltrexone to be beneficiary for 10. At four years follow up, six patients were rehabilitated without illegal substance use and two were substantially improved. Four of these were, however, on methadone maintenance. Naltrexone is useful as an adjuvant therapy to increase therapeutic potency in comprehensive therapeutic units for heroin addicts. The long-term effects are limited. Therapeutic units for heroin addicts should integrate both agonists and antagonists in their psychosocial programs.

Adult↗
PubMed2003

[Naltrexone in the treatment of addiction].

BACKGROUND: Naltrexone is a well-known opioid antagonist that has attracted increased attention with respect to new techniques in detoxification, methods for improving compliance, and new indications. Naltrexone 50 mg Revia recently obtained registration in Norway as a pharmaceutical product. A review of its pharmacological properties and documentation of clinical use is merited. METHODS: Basic neurobiological descriptions are cited from review publications. In addition, Medline, Embase and the Cochrane library have been searched for evidence-based evaluations. RESULTS AND INTERPRETATION: The basic antagonist effect is proven beyond doubt. Clinical dosages give few and moderate side effects. The drug's two properties, blocking for exogenic opioid and modulating the endogenic opioid system, are both therapeutically useful. Its use in the treatment of heroin addiction is hampered by poor compliance; this might be improved by formulations with prolonged duration or by special therapeutic techniques. Usefulness in treatment of alcohol problems is documented but effect size is moderate and partly dependent on psychosocial therapeutic techniques. There is interesting but undocumented reports on usefulness with nicotine and cocaine addiction, with gambling problems, in impulsive behaviour and in several other areas.

Adult↗
PubMed2002

[Buprenorphine as maintenance treatment in rehabilitation of heroin addicts].

BACKGROUND: Buprenorphine is used for maintenance treatment of opiate abusers. METHOD: A literature review was carried out in order to describe buprenorphine's pharmacology, its clinical use in maintenance treatment, and its efficacy when compared to methadone. RESULTS: Buprenorphine is a partial agonist to the opiate mu-receptor and is therefore safer in overdose. The distress of abstinence is reduced compared to methadone. The potential for abuse is, however, considerable. Some patients may not be maintained well enough on buprenorphine. INTERPRETATION: Buprenorphine should be subject to the same considerations in maintenance treatment as methadone.

Buprenorphine↗