The role of the National Institute on Drug Abuse in the development of naltrexone.

Naltrexone was administered to 114 opiate-addicted business executives and 15 opiate-addicted physicians within a highly structured abstinence-oriented aftercare program following an inpatient detoxification program that used clonidine. The majority of patients successfully completed 6 months of naltrexone treatment without missed visits or drug-positive urines, and were still opiate-free at 12- to 18-months follow-up. The most successful outcomes were achieved by those who had entered treatment with unequivocal job jeopardy. Our findings suggest that naltrexone can be an extremely useful adjunct in the treatment of opiate addiction when administered to employed, motivated patients within a highly structured therapeutic program.