Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 529-534, November 1997

Naltrexone pharmacotherapy for opioid dependent federal probationers

  • James W. Cornish, MD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to James W. Cornish, MD, Treatment Research Center, 3900 Chestnut Street, Philadelphia, PA 19104-6178.
    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
  • ,
  • David Metzger, PhD

      Affiliations

    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
  • ,
  • George E. Woody, MD

      Affiliations

    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
  • ,
  • David Wilson, MEd

      Affiliations

    • United State Probation Office, Eastern District of Pennsylvania, Philadelphia, PA 19106 USA
  • ,
  • A.Thomas McLellan, PhD

      Affiliations

    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
  • ,
  • Barry Vandergrift

      Affiliations

    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
  • ,
  • Charles P. O'Brien, MD, PhD

      Affiliations

    • Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
    • Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA

Received 26 July 1996; received in revised form 7 March 1997; accepted 31 March 1997.

Abstract 

Federal probationers or parolees with a history of opioid addiction were referred by themselves or their probation/parole officer for a naltrexone treatment study. Participation was voluntary and subjects could drop out of the study at any time without adverse consequences. Following orientation and informed consent, 51 volunteers were randomly assigned in a 2:1 ratio to a 6-month program of probation plus naltrexone and brief drug counseling, or probation plus counseling alone. Naltrexone subjects received medication and counseling twice a week, controls received counseling at similar intervals. All therapy and medication were administered in an office located adjacent to the federal probation department.

Fifty-two percent of subjects in the naltrexone group continued for 6 months and 33% remained in the control group. Opioid use was significantly lower in the naltrexone group. The overall mean percent of opioid positive urine tests among the naltrexone subjects was 8%, versus 30% for control subjects (p 〈 .05). Fifty-six percent of the controls and 26% of the naltrexone group (p 〈.05) had their probation status revoked within the 6-month study period and returned to prison. Treatment with naltrexone and brief drug counseling can be integrated into the Federal Probation/Parole system with favorable results on both opioid use and re-arrest rate.

Keywords:  naltrexone, opioid dependence, parole, probation, substance dependence

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 Work supported by NIDA Grant DA05186. Thanks to the Federal Judges, U.S. Probation Officers and management staff of the Eastern District of Pennsylvania for their tremendous support and invaluable assistance. Narcan® brand naloxone, ReVia® brand naltrexone, and patient brochures describing ReVia® were generously supplied by DuPont Pharmaceuticals. Thanks also to Assunta Cuccia, Phase Four Manager, DuPont Pharmaceuticals for continuous professional support.

PII: S0740-5472(97)00020-2

Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 529-534, November 1997