It is this axis in the CNS where many of the clinical uses for long acting opioid antagonists are involved. The mu opioid receptor is felt to play a role in the euphoria induced by alcohol intoxication. Opioid Detoxification Naltrexone has been used for over 20 years in detoxifying patients with opioid dependence. In a double-blind, placebo controlled trial, opioid dependent patients receiving a combination of clonidine and naltrexone exhibited transient, slight withdrawal symptoms. Patients were discharged with no withdrawal symptoms.
Naltrexone appears to be useful in preventing recidivism in opioid abusers.
All treatment successes have required intensive counseling programs, but regardless of the type of counseling, the naltrexone treated groups do better. Opioid Overdose Patients with opioid overdose present clinically stuporous to comatose with pinpoint pupils and decreased respiratory rate. Blood pressure remains normal until late decompensation leads to hypotension. A lethal overdose of morphine in the non-tolerant individual is 120 mg. A prospective non randomized phase II trial of nalmefene in opioid overdoses gave 1-10 boluses of either 0.5 mg or 1.0 mg of nalmefene to such patients.