Nalrexone Facilitated Discontinuation of Buprenorphine

Exclusion Criteria

• •1. Significant current suicidal risk or 1 or more suicide attempts within the past year
• •2. History of accidental drug overdose in the last three years defined as an episode of opioid-induced unconsciousness or incapacitation, whether or not medical treatment was sought or received.
• •3. Positive serum pregnancy test, lactation, or unwillingness to use a satisfactory method of birth control
• •4. Active psychiatric disorder which might interfere with participation or make participation hazardous, including DSM-IV organic mental disorder, psychotic disorder, or bipolar disorder with mania
• •5. History of allergic reaction, adverse reaction, or sensitivity to any study medication.
• •6. Acute hepatitis with SGOT or SGPT \> 3 times the upper end of the laboratory normal range (chronic hepatitis is acceptable as we have found naltrexone treatment well tolerate and safe among patients with chronic hepatitis)
• •7. Currently prescribed or regularly taking opioids for chronic pain
• •8. Current participation in another intensive psychotherapy or substance abuse treatment program, or participation in another treatment study.
• •9. Opioid dependence is not well-managed, and characterized by relapses, slips, or missed doses
• •10. Concurrent treatment with psychotropic medications which may interact adversely with naltrexone, such as duloxetine and valproic acid.