EASEPRESS 3.3
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Should You Buy Some ReVia? What is ReVia? It is patented medicine which is clinically called naltrexone. How do you pronounce it? I get away with pronouncing it ree-VY-ah. It came along in the 1970s. Naltrexone is an opioid antagonist which is not to be confused with an agonist. Antogonists prevent nuerotransmitters from arcing to a nueroreceptor in the brain. The arcing to the receptor which occurs with opiate absorption is what makes the opiate so pleasant to users. Prior to the development of naltrexone, pharmacology's answer to opiate craving was the agonist methadone. An agonist, rather than blocking the receptor, fills it. With the receptor filled with a (opioid) chemical rather than an opiate, the desire for the opiate is reduced, if not eliminated. Methadone is kind of a passive thing. It fills the receptor, but there is no "euphoric effect." Naltrexone also has no theraputic psychotropic effect. It is just there to make sure that you recieve no pleasure from an opiate. It also has shown good results for alcohol problems. Alcohol promotes the release of "natural" (endogenous) opioids -- endorphines. Naltrexone will block those too. Results? How good are these results? They are probably about the same as those produced for decades with disulfiram, which is better known by the trade name Antabuse. The literature which I have found ALL suggests ReVia as an adjunct to primary treatment (therapy and support)1. Nothing I have read has suggested that naltrexone is a magic bullet. For that matter, regarding it's supposed potential for alcohol excess, nothing has suggested that is is superior to disulfiram. There are some advocates out there who believe that alcohol addicts using alcohol while on naltrexone might well extinguish that pleasure seeking habit (boozing). The theory being that (regardless of the memory of booze prior to the antagonist) the addict will associate alcoholic beverages with something other than pleasure. "Extinguishing" refers to repeating a behavior until you learn that it is stupid to go on repeating it. Often patients on naltrexone even report taht alcoholic beverages taste offensive. One issue which seems to come up in discussoin on the internet about naltrexone is that Dupont is being very careful to point out that it is MEANT to be used along with some form of psychosocial therapy. Hence, psychiatrists and especially general practitioners are reluctant to just write you a script. They are inclined to either defer to treatment professionals or to divert you to some form of group support or coping skills training. If you deny the group support, they will be inclined to deny you the antagonist! One writer (Jari H (http://www.utu.fi/~jarhav) suggested that the demand for therapy to correspond with the prescription is "spawning flourishing commercial enterprises to provide said therapies. A new era of treatment industry is seeing the light of day?" I have not used naltrexone for any duration. When I was prescribed it in the mid '90s, the idea of blocking "euphoric effects" by even my own endorphines seemed too pricey. Like I did with Antabuse earlier in my career, I simply chose to not indulge. My legion of treatment counselors would have told me that I was "in relapse" and "not serious" about "recovery". Such diligence and the world of pharmacology are just more troubling than spontanaity and risk are to me. I chose risk. I suspect that I am not alone. ReVia is one of those expensive drugs. You have to work a couple of days to afford a two week supply. Further, for folks who are averse to any concurrent "primary treatment" of support groups, platitudes, and psyche detailing, a good charge of transmitters seems quite alluring. If you are having great success with ReVia or Nalafeme, please do write EASEPRESS and elucidate. I do not want to discourage the utilization of antagonists; I want merely to point out the limits of them. If there were no risk or side effects, heck, I'd advocate a naltrexone implant for addicts who's reserve is getting them nowhere! However, despite Dupont Merck's success with ReVia, the strong use of the word "adjunct" in most literature, makes the antagonist seem no more effective than nutritional therapy which seems less risky...especially if overdosing is facilitated by the antagonist. The drug naltrexone does not decrease the desire for pleasure or for whatever getting high provides. It just blocks the effects of the opiate or endorphines. This is why the extinguishing is often encouraged. "Go ahead, try boozing on naltrexone. When you realize boozing is no good, you will be deconditioned." The jury is still out on what happens when you quit the naltrexone after you've extinguished your habit. Remember that the price of the drug is very high. Stanton Peele reacts to ReVia online: " You know, for centuries, therapies have been built on alternate drug experiences that block or replace opiate and other cravings (heroin was introduced as a chemical substitute for morphine, alcohol, and cocaine; barbiturates were likewise marketed for their anticraving effects; and so on). "Obviously, a drug that reduced the likelihood of alcoholic relapse, even after drinking, has a place in treatment. But, I strongly suspect early enthusiasm about naltrexone in alcoholism treatment will quickly fade. "This has already occurred in heroin addiction treatment, and especially in the country (Australia) where its use was most quickly and widely embraced (for use by general medical practitioners). Of course, naltrexone has been used for decades in heroin treatment. There was widespread enthusiasm for its generic use in Australia, and GPs were given prescribing privileges for it. There has now been considerable retrenchment. James Bell, in Australia, indicated, "We have enough research in Australia to say Naltrexone is of limited value [for opiate addicts]. Overseas evidence suggests only about 10 percent do well on it." Of course, any improvement with Naltrexone has to be matched with the improvement shown by untreated addicts. "Bell's evaluation of the actual (as opposed to experimental) use of Naltrexone in the Medical Journal of Australia was scathingly negative: not only did Naltrexone fail to end addiction for virtually all addicts, it increased the risk of overdose. Of 30 addicts prescribed naltrexone, by three months only six were still taking it, four of whom still sometimes used heroin."
SIDE Effects Like Antabuse, naltrexone is not for folks with troubled livers. Naltrexone is not for folks with physical pain to treat, unless they are informed. For starters, narcotic pain relief from morphine or codeine will be all but ineffective if those opiate receptors are blocked. You have to use non-narcotic pain relievers if you use naltrexone. Sorry. Word has it that nausea and lethargy are not uncommon either. The main thing is the blocking of pleasure and of pain by antagonists. naltrexone has also been studied in the treatmnet of autism. All In All I think that antagonists and agonists are good things to awaken people who want
just a little extinguishing, if you'll forgive the labrat terminology. If you find
that alcohol or especially an opiate that you are fond of can be defeated by
changing your brain chemistry, you might be awakened to what it really is and it
will lose its mystical illusion. On the other hand....if you see just how much time
and money goes into licking the pursuit of pleasure, it can seem frivolous to try to
keep up! I asked the Hennepin County Library for sales figures on naltrexone, nalafeme, and antabuse. They came up empty but offered this: "Search engines on the Internet were searched [for naltrexone]. One article on YahooFinance did mention Naltrexone. You can find it at: http://biz.yahoo.com/e/l/b/brl.html. ". The brand name for [nalmefene hydrochloride] is Revex, manufactured by Baker-Norton Pharmaceuticals. Its parent company is IVAX. For more information on that company you can refer to their website:www.ivax.com. Naloxone was listed by the brand name Narcan, produced by Endo Pharmaceuticals (www.endoinc.com.) Wyeth-Ayerst (www.ahp.com/wyeth.htm) produced disulfirim (Antabuse). For additional information you might try contacting the University of Minnesota Biomedical Library 612-626-3260 or the Hill Reference Library in St. Paul 651-265-5500. If you have additional questions, please feel free to call us directly at 952-847-5933." Ref. 1. Copyright © 1996-98 by Vimy Park Pharmacy.
"Naltrexone or Revia acts for 24 hours, thus a once daily dose is required. However, addiction counselling and supportive therapy is essential. With Naltrexone or Revia there are less craving, fewer drinking days, fewer drinks per occasion, and a lower incidence of relapse.... "...Because addiction counselling and supportive therapy are an integral part of therapy with Naltrexone or Revia, people must be willing to be involved in a complete program."
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