Naltrexone induction: psychologic and pharmacologic strategies.

Attempts ot improve naltrexone retention during the induction and stabilization phases of treatment are described. During induction, street addicts appear to do better than postmethadone patients and to benefit more from counseling. Inpatient withdrawal and induction appear to be more successful than outpatient, but use of new techniques such as clonidine and clonidine/naltrexone may improve results in outpatients. Prolonged withdrawal symptoms and drug craving appear to contribute to the high dropout rate during stabilization. Pharmacologic and psychological methods of treatment, and future research strategies for these first two parts of naltrexone treatment, are summarized.