Episode 50 – From Drug Abuser to Addiction Consultant
Ian is an addiction expert with a fascinating story of change & transformation
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If you have a Wedgewood naltrexone implant, you don’t need to take naltrexone by mouth until the implant wears off. We advise that a second implant, if you are having one, should be inserted between 4-5weeks after the first one to try to ensure that there is some overlap between implants. If it turns out that your implants last longer than the average of around 6 weeks, subsequent implants can be put in at slightly longer intervals. (Alternatively, consider an O’Neil longer-acting implant). If you feel confident that you would take oral naltrexone reliably after the first one or two implants, you should take one tablet daily or two to three tablets every two or three days. Please arrange to take naltrexone tablets under supervision, preferably dissolved in coffee or juice to discourage cheating. People taking unsupervised naltrexone tend to stop it too soon and are much more likely to relapse. If you are running short of naltrexone, half a tablet daily will probably still provide adequate opiate blockade.
Patients with an implant should make sure they keep a small supply of naltrexone tablets as an emergency reserve. This can be used if there is an unexpected delay before the next implant or if a prescription for tablets gets delayed. Implants of any type occasionally get infected. Usually, this clears up quickly with antibiotic treatment but an abscess could develop and the implant could be lost if the abscess bursts. This seems to be very rare. If it does happen, you should take oral naltrexone half to one tablet daily and seek further advice from us immediately.
Being on naltrexone means that opiates will be ineffective for pain relief if you have an accident or need surgery. Fortunately, there are pain-killing drugs which are not blocked by naltrexone. These include nitrous oxide (laughing gas) which most ambulances carry and the anaesthetic drug ketamine. Make sure that you always wear your naltrexone warning card and/or wear your warning tag.
Swelling at the implant site two or three months after insertion sometimes occurs. It is usually painless and usually settles without treatment. Very occasionally, infection or tissue reaction at the implant site could lead to a hole or ulcer forming in the skin. This could require surgical treatment but we stress that serious reactions seem to be very rare. Phone us if you are worried.
