THE ROLE OF ADDICTION SEVERITY AND PATIENT HEALTH PERSPECTIVE IN NALTREXONE VERSUS METHADONE TREATMENT FOR OPIATE ADDICTION
An advancement in the treatment of opiate addiction involves the use of naltrexone antagonist medication to assist patients in maintaining opiate-free periods. Naltrexone may be preferable to alternative modalities such as methadone maintenance in terms of physical, psychological, and social advantages. However, naltrexone treatment compliance has been poor and problematic, perhaps partly because of naltrexone's relative lack of intrinsic reinforcing properties compared to methadone's. Furthermore, naltrexone and methadone treatment modalities have not been directly compared. This research investigated the role of addiction severity and patient health perspective, utilizing measures of locus of control, health locus of control, health value, and somatization, in a comparative, short-term (12 weeks) study of clinical outcome (retention and drug abuse).^ It was hypothesized that naltrexone patients would have more favorable pre-treatment addiction severity and health perspective ratings than methadone patients, and that addiction severity would be inversely related to favorable outcome for all subjects. It was also hypothesized that health perspective would be more highly correlated with favorable outcome for naltrexone patients than for methadone patients. Finally, intercorrelation of health perspective variables was predicted for all subjects.^ Results suggested that naltrexone patients are significantly less severe pre-treatment in aspects of addiction of severity (drug and alcohol abuse), and more internal in health locus of control as predicted. Also, unexpectedly, naltrexone patients were not more internal in locus of control, higher in health value, or lower in somatization. Addiction severity was significantly related to outcome in terms of drug abuse as hypothesized, but not in terms of retention. Unexpectedly, health perspective variables were not more highly correlated with outcome for naltrexone patients. Locus of control and health locus of control were significantly correlated as expected; remaining health perspective variable correlations were non-significant.^ The implications of these findings for research and the clinical use of naltrexone were discussed. Specifically, symptom severity assessment appears useful for clinical prediction. Also, naltrexone and methadone treatments seem comparable in terms of drug abuse outcome. Finally, future research should focus on indentifying other patient factors (for example, ego strength, motivation, and therapy/counseling involvement) that may be related to naltrexone treatment outcome. ^
OSBORN, ELIZABETH, "THE ROLE OF ADDICTION SEVERITY AND PATIENT HEALTH PERSPECTIVE IN NALTREXONE VERSUS METHADONE TREATMENT FOR OPIATE ADDICTION" (1984). ETD Collection for Fordham University. AAI8506351.