To the Editor: Gibson and colleagues recently reported opioid overdose deaths occurring in patients with naltrexone implants.1 The article is of great clinical significance, identifying that patients can override the effect of naltrexone and experience fatal opioid toxicity. However, it fails to address some important clinical and forensic issues that the five deaths highlight.
- 1. Gibson AE, Degenhardt LJ, Hall WD. Opioid overdose deaths can occur in patients with naltrexone implants. Med J Aust 2007; 186: 152-153. <MJA full text>
- 2. Digiusto E, Shakeshaft A, Ritter A, et al. Serious adverse events in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD). Addiction 2004; 99: 450-460.
- 3. Sullivan MA, Comer SD, Nunes EV. Pharmacology and clinical use of naltrexone. In: Strain EC, Stitzer ML, editors. The treatment of opioid dependence. Baltimore: Johns Hopkins University Press, 2006: 295-320.
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