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Antagonist Treatment for Opioid Use Disorder: Development of Antagonist Treatment: Antagonists Versus Agonist Treatments Pros and Cons 

Antagonist Treatment for Opioid Use Disorder: Development of Antagonist Treatment: Antagonists Versus Agonist Treatments Pros and Cons
Chapter:
Antagonist Treatment for Opioid Use Disorder: Development of Antagonist Treatment: Antagonists Versus Agonist Treatments Pros and Cons
Author(s):

Stephanie Lee Peglow

, Joshua Moran

, and Matthew Keats

DOI:
10.1093/med/9780190920197.003.0010
Page of

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date: 28 June 2022

This chapter focuses on the use of oral and injectable extended-release naltrexone for opioid use disorder. The historical development of naltrexone and its pharmacology are discussed. The chapter presents the clinical application of initiating naltrexone therapy, including the transition to and from methadone and buprenorphine and the utility of the naloxone challenge test. The pros and cons of naltrexone are reviewed and compared to first-line agents: methadone and buprenorphine. In addition, the efficacy of different formulations of naltrexone is addressed. Last, this chapter reviews the use of naltrexone in special populations including in criminal justice, adolescents, pregnant or childbearing patients, and other vulnerable populations.

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