Naltrexone implants: providing hope in long-term recovery

Naltrexone implants: providing hope in long-term recovery

THE WAVE CLINIC > Naltrexone implants: providing hope in long-term recovery

Naltrexone at The Wave

The Wave is a specialist centre for the treatment of teenagers and young adults, where we believe that Naltrexone can be incredibly useful in the long-term treatment of some young people.

Naltrexone at The Wave is offered only as part of a long-term treatment plan for young people who have completed at least 12 weeks of our primary residential programs. Naltrexone in young people is used in conjunction with comprehensive treatment plans, including psychotherapy, family therapy and psychiatric management of co-occurring conditions. 

What is Naltrexone?

Naltrexone is an opioid antagonist. It is not an opioid and is not addictive; therefore, it does not cause withdrawal symptoms for those who choose to discontinue use. 

Naltrexone comes in tablet form (alcohol use disorder), injections (opioid use disorder) and implants. It is only available by prescription and under the guidance of specialist medical teams.

Naltrexone belongs to a group of medications that are used to prevent some of the usual feelings and experiences that accompany drug and alcohol use and some maladaptive behaviours. Naltrexone blocks the effects of opiates whilst simultaneously decreasing the craving for alcohol and opiates and shortening relapse episodes. 

The FDA approved Naltrexone in April 2006 for the treatment of alcohol dependence. In 2010, this approval was extended to include long-acting injectables. 

Naltrexone is currently used in the treatment of heroin addiction, Fentanyl addiction, Codeine addiction and alcohol dependence, and other drugs in the opioid family.

What is Vivitrol?

Revia and Vivitrol are the brand names for the generic drug Naltrexone for extended-release injectable suspension (Naltrexone XR).

Vivitrol injections are usually given monthly, for at least 12 months, to allow the individual to build a solid recovery. 

Daily, monthly or six-monthly 
Daily Naltrexone is in pill form and most often used to combat cravings in alcohol use disorder. Naltrexone tablets are not routinely used in young people under the age of 18.

Intramuscular, extended-release Naltrexone is a medication-assisted treatment (MAT) most often used in substance use disorder. Injections are usually given monthly, for at least 12 months. Whilst this offers significant benefits, there are medication compliance and appointment attendance issues for some.

Dr George O’Neil, from The Perth Naltrexone Implant Service, understood that compliance with daily or even monthly medications by pill or injection in young people was incredibly sporadic. Missing appointments and non-compliance with medication can lead to relapse, often with serious or even fatal consequences.

Dr O’Neil, therefore, developed an extended-release formulation, which can be effective for up to six months. This development has provided new hope to many young people and their families, as relapse rates and periods of extended stability increase the overall prognosis for recovery from substance use disorders. 

Dr R. Suliaman, Medical Director at The Wave Programs, was delighted to receive training in person from Dr George O’Neil in 2015 and 2017. Understanding the benefits, use and application of Naltrexone implants, Dr Rasyid holds regular clinics for Naltrexone implants at The Wave, Kuala Lumpur Naltrexone Implant Service. 

Is Naltrexone a cure for addiction?

It is important to understand that Naltrexone is not a ‘cure’ for addiction. Naltrexone can be useful as part of a robust treatment program. 

Naltrexone XR and implants are both administered after detox in completed.

It is essential to contact a medical practitioner before stopping substances or alcohol. Going ‘cold turkey’, or stopping suddenly, can be dangerous and in some cases fatal. 

What is an implant?

An implant is a small pellet that is placed under the skin during a simple medical procedure. During the procedure, a tiny incision is made, either on the abdomen or the back of the upper arm, through which the implant can be inserted. It is relatively painless and takes no longer than a few minutes. 

The Naltrexone implant then slowly dissolves into the body, releasing a stable and effective dose of Naltrexone over an extended period. Implants usually last between 6–9 months. 

The implant not only works for a sustained period of time but also provides an increased level of protection against overdose and sustained relapse.

What are the benefits of implants?

Untreated or releasing opioid addictions are associated with poor outcomes. Many millions of young people and their families are affected by opioid use disorder globally. Slow release, long-acting and implantable Naltrexone may improve these outcomes.

For young people who have an increased risk of impulsivity, or those young people who have had a series of treatment episodes with further slips, Naltrexone can provide additional assistance.

Impulsivity can lead to immediate gratification. Young people with high levels of impulsivity may act out on old behaviours without due consideration of the consequences. This can quickly spiral into dangerous levels of drug use and other maladaptive behaviours. Naltrexone can effectively ‘block’ the effects of the first use, preventing the user from experiencing the feelings of ‘high’ that usually accompany drug use or some other behaviours. This can be useful in preventing further dangerous events and the use of maladaptive behaviours. 

Does the implant need to be removed?

No. This is one of the added benefits. Naltrexone slowly breaks down and dissolves in the body; therefore, implant removal is not necessary. 

Are Naltrexone implants suitable for everyone?

No. Naltrexone is not a short cut to recovery, neither is it suitable for everyone. 

Naltrexone should only be used as part of a complete treatment program.

Naltrexone alone is significantly less effective than Naltrexone administered as part of a longer-term treatment program. Behavioural changes, psychiatric diagnosis and trauma treatment, are essential in sustained recovery for young people and their families. 

Naltrexone use in the treatment eating disorders

Recent studies have indicated a positive response on the symptoms of Binge Eating Disorder (BED) with combined psychotherapy and Naltrexone treatment. 

The opioid reward system has been shown to be engaged in binge eating and purging; bulimic patterns of eating disorders. As an opioid antagonist, Naltrexone may effectively reduce the binge/purge cycle by actively suppressing the reward system.

Naltrexone has proved to be safe and well tolerated in teenagers and young adults.

Naltrexone should only be used as part of an extended treatment program, including psychotherapy and psychiatric management.

Naltrexone use for mental health and behavioural concerns

Naltrexone has shown some promise in the treatment of Trichotillomania and Skin Picking Disorders. There is also significant interest in the off-label use for some cases of self-harm, gambling and other behavioural health concerns. 

Treatment fees *

Naltrexone Assessment Initial Appointment – 250 USD 
Naltrexone Implant (6 months) – 1250 USD 
Vivitrol Injection (1 month) – 250 USD

Overseas and international patients will need to plan a short stay in Kuala Lumpur. We recommend our hotel partners at The Four Seasons Hotel, Kuala Lumpur, who can provide corporate booking rates upon request. 

*Treatment charges from January 2021. Costs may be subject to change.

Naltrexone outpatient appointments

We are able to provide Naltrexone Implant Services for adults at our outpatient clinics in Kuala Lumpur, Malaysia. 

We accept international patients and those who currently reside in Malaysia.

The Naltrexone Implant Service is also available to the young people and their families in our primary residential programs. 

Outpatient appointments, to assess suitability and medical need, are available with our Resident Medical Team. Appointments should be made through our outpatient appointment booking service with our on-duty psychiatrist. 

There’s Always Hope

Recovery is not a journey that should be taken alone. Do you have questions?

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Are you looking to start the path to healing? We’d love to talk to you.

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