Contingent naloxone (N allylnoroxymorphone) treatment of the paroled narcotic addict

This is a presentation of the results of pilot and controlled research on the effectiveness of the contingent (upon narcotic drug use) administration of 500-2,000 mg daily, of the narcotic antagonist, naloxone (N allylnoroxymorphone), to paroled narcotic addicts enrolled in a urine monitoring program conducted in a metropolitan based outpatient clinic. Criteria of effectiveness, which include clinic attendance, the extent of narcotic drug usage, and final disposition at the end of a 6 month treatment period, are viewed in relation to already established baseline results with a sample of patients processed through the same clinic over a 5 yr period prior to the introduction of naloxone treatment. Although results of the pilot study are encouraging, indicating longer patient involvement and less reinstitutionalization than baseline values, the results of the controlled evaluation reveal no benefit from contingently administered naloxone beyond placebo reactivity, which appears to be substantial in the contigent approach. The results are discussed in terms of given sample characteristics, and suggestions are offered regarding the development of new narcotic antagonist treatment approaches.