Title : How opioid and benzo receptor antagonists can return the HPA axis to normal and correct stress related disorders such as addiction, neuroinflammatory diseases such as anxiety, depression and migraines
Addiction is managed by
Recovery based organisations meeting psychosocial needs in a protected setting.
Medical practitioners are using agonists typically to the opioid and GABA systems supplemented by antidepressants and antipsychotics.
Medical practitioners using opioid and benzo antagonists.
Each of these groups competes for attention and funding often at the expense of each other.
The outcomes for each of these three approaches differ:
While recovery based groups can help a percentage of patients to change a lifestyle, the return to the home following a period of artificial protection in a rehab environment can be made safer by use of opioid antagonists delivered in a reliable way for a year or more following the initial recovery. In the US there are estimated to be 3000 residential organisations (NYT Dec 2018) with 50% offering no medications to protect patients from overdose on return to the home.
The use of opioid agonists reduces the risk of opioid overdose death but increases the length of time that people are held in opioid dependence. These have been the best established approaches to tackle opioid dependence in the absence of alternative treatments.
In 2012 the University of Western Australia defined that the risk of opioid overdose death following detox off opioids was 25 times higher if the detox was supported by oral naltrexone versus sustained release naltrexone. This was a 28,000 patient year study. In the case of implant naltrexone and flumazenil infusions and implants the patient is returned to a non-opioid dependant state with post withdrawal anxiety controlled without the risks of benzodiazepine dependence. In the UK there is no sustained naltrexone delivery systems of treatment currently available despite registration in the US since 2006.
In our presentation we will discuss the treatment of opioid, amphetamine, cannabis and benzodiazepine addictions with opioid and benzo antagonists. We will also discuss the 12,000 patients treated with this approach in Perth, and the NIDA funded studies on our implant work in the US. We will also discuss our work in the UK.