Buprenorphine Stabilization and Induction Onto Vivitrol for Heroin-dependent Individuals

Exclusion Criteria

• •1. Reported treatment with methadone in the last 3 months or positive urine toxicology for methadone on the day of consent
• •2. Maintenance on, or regular use of buprenorphine or other prescription opioids
• •3. Pregnancy, lactation, or failure in a sexually active woman to use adequate contraceptive methods.
• •4. Active medical illness which might make participation hazardous, such as untreated hypertension, acute hepatitis with AST or ALT \> 3 times normal, AIDS (CD4 count under 200 currently or medically ill with an opportunistic infection), unstable diabetes, cardiovascular disease.
• •5. Active psychiatric disorder which might interfere with participation or make participation hazardous, including DSM-5 Schizophrenia or any psychotic disorder, severe Major Depressive Disorder, or suicide risk or 1 or more suicide attempts within the past year.
• •6. Physiologically dependent on alcohol or sedative- hypnotics with impending withdrawal. Other substance use diagnoses are not exclusionary.
• •7. History of allergic or adverse reaction to buprenorphine, naltrexone, naloxone, clonidine, or clonazepam.
• •8. Chronic neurocognitive disorder
• •9. History of accidental drug overdose in the last 3 years as defined as an episode of opioid-induced unconsciousness or incapacitation, whether or not medical treatment was sought or received.
• •10. Painful medical condition that requires ongoing opioid analgesia or anticipated surgery necessitating opioid medications
• •11. Fentanyl only use, supported by a urine toxicology that is positive for fentanyl only and negative for all other opioids.
• •12. Court mandated to treatment