A new Effectiveness Bank bulletin documents the groundbreaking Norwegian randomised trials of
long-acting naltrexone implants for the treatment of opiate addiction. Short of surgical removal, in
theory for several months the procedure irreversibly prevents heroin addicts experiencing the
desired effects of the drug, providing an extended opiate-free space during which a new non-drug
focused life can be constructed.

The Norwegian studies tested implants against normal aftercare for patients leaving inpatient
treatment, and against methadone maintenance as a bridge to community treatment for prisoners coming
to the end of their sentences. They showed that implants can be an effective and lasting aid to
curbing opiate use for the small minority of patients motivated to aim for opiate abstinence and
prepared to accept that opiate effects may be unavailable to them for six months.

To view the whole bulletin click the following link:
http://findings.org.uk/docs/bulletins/Bull_27_02_12.php
or click the links below to view an entry in the bulletin. If clicking does not work, paste the link
in to your web browser address box, being sure to enter the whole address.

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*updated* IMPLANTS HELP SUSTAIN HEROIN ABSTINENCE AFTER DETOXIFICATION
In the first randomised trial, implants which block opiate-type drugs for months helped heroin
addicts in Norway avoid relapse after detoxification. Though heroin use was tackled more effectively
than by normal aftercare, other advantages were curiously limited: there were none relating to other
forms of substance use nor to depression, work, or criminal activity.
http://findings.org.uk/count/downloads/download.php?file=Kunoe_N_1.txt

*new* IMPLANTS EQUAL METHADONE AS A PRISON-COMMUNITY BRIDGING TREATMENT
In the first study of its kind, as a way of bridging the period after release formerly
opiate-dependent prisoners in Norway were randomly allocated to a six-month implant which blocks the
effects of heroin or to methadone which substitutes for heroin. Among the minority interested in
either option, they led to equivalent reductions in opiate use and crime.
http://findings.org.uk/count/downloads/download.php?file=Lobmaier_P_3.cab

*new* FALSE CONFIDENCE LEADS FORMERLY ADDICTED PRISONERS TO REJECT IN-PRISON TREATMENT
From the same prison study, an exploration of why just 27 of 111 prisoners seen by researchers who
had been opiate dependent before prison were prepared to start either of the treatments on offer.
Many rejected treatment because they (probably wrongly) believed they would sustain abstinence on
release.
http://findings.org.uk/count/downloads/download.php?file=Lobmaier_P_2.cab

*new* DESPITE IMPLANTS A QUARTER OF PATIENTS REPEATEDLY USED OPIATES
Amalgamated results from all the Norwegian trials show that despite being motivated to sustain
abstinence and implanted with a drug which should have blocked the effects of opiates, most
opiate-dependent patients used opiates and about a quarter did so repeatedly - warning signs that
the treatment is not working.
http://findings.org.uk/count/downloads/download.php?file=Kunoe_N_2.cab

*new* HALF IMPLANTED PATIENTS OPT FOR A SECOND IMPLANT
A further report amalgamating results from all the Norwegian trials comes to the encouraging
conclusion that patients who do relatively well on an initial implant will be willing to have a
second one, giving them up to a year during which to construct a life no longer based on opiate use,
and that this can be as many as half those initially implanted.
http://findings.org.uk/count/downloads/download.php?file=Kunoe_N_3.cab

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interventions. Findings is managed by DrugScope, Alcohol Concern and the National Addiction Centre.
The Effectiveness Bank is supported by Alcohol Research UK.
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