Naltrexone implants in opioid dependence: a proof of mechanism study with pk and pd measures

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Heroin addiction is a major social and health problem that results in many thousands of deaths per year, and is also a cause of many other health social and criminal problems. Current treatments are effective but they rely on keeping addicts on alternative drugs such as methadone and buprenorphine that effectively keep them ?stoned? ? sp limiting the ability to return to work and also necessitating daily attendance at clinics or pharmacies. A much better strategy would be to use a drug to block the brain sites of action of heroin so that the addict got no effect when it was taken. This is proven to work in people with high motivation to take the blocker e.g. doctors, but again daily dosing is required so that it is easy to stop and then resume heroin use. This grant uses a new blocker preparation that is implanted under the skin [like the long-acting depot contraceptive pill] and so will work for between 3-6 months. Before using this as a treatment we need to explore just how long the blockade last so that the timing of repeat implants can be made and this grant is designed to do this. From our findings we should be able to design the optimal treatment package for heroin addiction with this exciting new approach.