Evidence map›Paper›PMID 21513688›Full record

Trial reportJournal of studies on alcohol and drugs2011

Problem drinking and low-dose naltrexone-assisted opioid detoxification.

Paolo Mannelli, Kathleen Peindl, Ashwin A Patkar, Li-Tzy Wu, Haresh M Tharwani, David A Gorelick

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of studies on alcohol and drugs, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Opioid antagonists with minimal sedation for opioid withdrawal.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Detoxification treatments for opiate dependent adolescents.The Cochrane database of systematic reviews · 2014
    Pooled it
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Paolo MannelliDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2218 Elder Street, Suite 123, Durham, North Carolina 27705, USA. paolo.mannelli@duke.edu
Kathleen Peindl
Ashwin A Patkar
Li-Tzy Wu
Haresh M Tharwani
David A Gorelick
Duke Medical Center · USDuke University · USNational Institute on Drug Abuse · US

Funding

Place of low-dose naltrexone in opiate detoxificationR21DA015469 · NIDA · THOMAS JEFFERSON UNIVERSITY · PI MANNELLI, PAOLO · 2003 to 2005
$557k
Intramural NIH HHSNIDA NIH HHS DA15469NIDA NIH HHS R21 DA015469
6 · The paper itself

Abstract

objectiveThe influence of alcohol use on opioid dependence is a major problem that warrants a search for more effective treatment strategies. The addition of very-low-dose naltrexone (VLNTX) to methadone taper was recently associated with reduced withdrawal intensity during detoxification. In a secondary analysis of these data, we sought to determine whether problem drinking affects detoxification outcomes and whether symptoms are influenced by VLNTX use.

methodOpioid-dependent patients (N = 174) received naltrexone (0.125 or 0.250 mg/day) or placebo in a double-blind, randomized design during methadone-based, 6-day inpatient detoxification. Alcohol consumption was assessed at admission using the Addiction Severity Index and selfreport. Outcome measures were opioid withdrawal intensity, craving, and retention in treatment.

resultsProblem drinking-opioid dependent patients (n = 79) showed episodic heavy alcohol use and reported increased subjective opioid withdrawal intensity (p = .001), craving (p = .001), and significantly lower rate of retention in treatment (p = .02). Individuals with problem drinking and opioid dependence who were treated with VLNTX (n = 55) showed reduced withdrawal (p = .05) and a lower rate of treatment discontinuation (p = .03), resuming alcohol intake in smaller numbers the day following discharge (p = .03). Treatment effects were more pronounced on anxiety, perspiration, shakiness, nausea, stomach cramps, and craving. There were no group differences in use of adjuvant medications and no treatment-related adverse events.

conclusionsHeavy drinking is associated with worse opioid detoxification outcomes. The addition of VLNTX is safe and is associated with reduced withdrawal symptoms and better completion rate in these patients. Further studies should explore the use of VLNTX in detoxification and long-term treatment of combined alcohol-opioid dependence and alcohol dependence alone.

Indexed as

AdultAlcohol DrinkingDouble-Blind MethodFemaleFollow-Up StudiesHumansMaleMethadoneNaltrexoneNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersSeverity of Illness IndexSubstance Withdrawal SyndromeTreatment OutcomeYoung AdultMethadoneNaltrexoneNarcotic Antagonists

Identifiers

PMID21513688
PMCPMC3084365
OpenAlexW2077277993

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.