Unplanned admissions to two Sydney public hospitals after naltrexone implants.

The Medical Journal of Australia
Nicholas LintzerisPaul S Haber

Abstract

To describe hospital presentations related to the use of naltrexone implants, an unlicensed product used in Australia for treating heroin dependence. Retrospective case file audit. Two Sydney teaching hospitals. Identified through referrals to Drug and Alcohol Consultation-Liaison services over a 12-month period, August 2006 to July 2007. Diagnosis, management and duration of admission. Twelve cases were identified: eight were definitely or probably related to naltrexone implants or the implantation procedure (rapid detoxification). Of these, six patients had severe opiate withdrawal and dehydration, with an average hospital stay of 2.3 days. One patient had an infection at the implant site, and one an underlying anxiety disorder requiring psychiatric admission. Three patients had analgesia complications, and one had unrelated cardiac arrhythmia. These severe adverse events challenge the notion that naltrexone implants are a safe procedure and suggest a need for careful case selection and clinical management, and for closer regulatory monitoring to protect this marginalised and vulnerable population.

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Citations

May 11, 2011·CNS Neuroscience & Therapeutics·Philipp P LobmaierHelge Waal
Mar 19, 2014·Drug and Alcohol Review·Francis Matthew-Simmons, Alison Ritter
Apr 24, 2008·The Medical Journal of Australia·Alex D WodakLloyd Sansom
Oct 22, 2008·The Medical Journal of Australia·D Martyn Lloyd-Jones
Nov 26, 2008·The Medical Journal of Australia·Mark Little, Lindsay M Murray
Nov 26, 2008·The Medical Journal of Australia·Colin L Brewer
Nov 26, 2008·The Medical Journal of Australia·Michael P W Kozminsky
Nov 19, 2010·British Journal of Hospital Medicine·Sanju George, Hamed Ekhtiari
Jun 23, 2009·Expert Opinion on Pharmacotherapy·Angela L StottsThomas R Kosten
Oct 13, 2009·Lancet·Paul S HaberBridin Murnion

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