Administering Naltrexone While Still Testing Positive For Opiates

[chillinwill]

A friend of mine (really a friend of mine and not me) has done heroin two days in a row and is supposed to go get her vivitrol shot (an extended release once a month naltrexone shot) tomorrow and her last usage was late monday night. Now, as far as I know, the doctors and the makers of Vivitrol say its best for somebody to be clean for 7-10 days with all opiates out of their system in order to get their shot. If the opiates aren't out of her system, it says she will go into severe withdrawal. However, my friend, lets call her J cannot test positive because if she does, she will be violated. So she was goin to use someone else's piss that is clean before she gets her shot. What are the chances that the naltrexone (its 380mg in a shot) after 1 1/2-2 days clean off opiates will send her into withdrawal?

[Fantasian]

Whats her previous use history prior to those 2 days?

It's unlikely to send her spiralling straight into it as it's extended release so she should have enough time to leave and get herself sorted but that said 1-2 days clean isn't long enough to precipitate no symptoms in SWIF's oppinion. But they should manifest at a later point (ie hours later)

[chillinwill]

J had been clean for roughly 2 months prior to that. She asked me to ask if people knew on here since she knows I'm a member and everything. How bad are these withdrawals going to be because in some articles, it says that the withdrawals with be severe enough that one will need to be hospitalized?

[Fantasian]

again it depends on how much was used on the two days but tbh with that record the withdrawal shouldn't be anything she hasnt handled before if she's on some sort of rehab program. While nalaxone as a drug does precipitate a worse withdrawal than just coming off without an opiate antagonist it shouldnt be a huge differance 2 days later if she's been clean prior to that, much of the opiate will have left her system anyway. It's difficult to accertain as administration of nalaxone will not make someone withdraw who is not dependant physically, so question would she have withdrawn some anyway in normal circumstances? The severity of withdrawal often comes from the rapid change when nalaxone is administered IV rather than the antabuse program SWIY is talking about.

Again as opiate withdrawals offer no life threatening risk while being massively unpleasant depending on a persons personal pain threshold and willpower could be effectively managed at home. (assuming no other co-mobidities/illness' are present like epilepsy for example)

[chillinwill]

Well its extended release naltrexone (not sure if that makes much of a difference) as both are antagonists....That's what I was thinking for J as well is that most of the opiates have left her body and she still might test positive for opiates but most are not on the receptors therefore when the naltrexone is administered, there won't be much heroin to kick of the receptors.

[Dickon]

There will be no withdrawal. You simply can't pick up a habit in two days, even if you've only been clean 2 months. Any discomfort she will feel will be purely in the mind. That said, going ahead with this kind of thing would certainly fuck with MY head, and in no small way. But physical w.d.s, no.

[chillinwill]

So if I'm reading what you all are saying right, J has nothing to worry about? This happened one other time with her when she was waiting to get her shot and had just come off 16mg/day suboxone and lied to her doctors and she went into major withdrawal when the naltrexone was administered because she had only been clean 12-24 hours or so. I just don't want anything to go wrong for her because she is a good friend of mine. Do you have to pick up a habit in order for someone to go throgh withdrawal if naltrexone is administered? I know for a fact she doesn't have a habit only after 2 days of using but from everything I have read, one could go into withdrawal if naltrexone is administered too early.

Also, I just got her to take a at home drug test and she tested positive for opiates

[Dickon]

Yes, you do need to pick up a habit before naltrexone precipitates w.d.s.

[chillinwill]

Well just an update....J called me and said everything went good and that she feels fine so thanks everyone for their help

[Fantasian]

no worries, glad we helped.

[Aberdonian]

Swim was on oral naltrexone for 18 months and a few times swim stopped the pills for 3 days, used heroin for a couple days then waited 48hrs and started the naltrexone again with no ill effects,swim wouldnt recommend much longer as he ended up hospitalized after pretending to take his pills but using for 3 weeks continously until he swallowed a naltrexone by mistake and was extremely ill! your friend should be fine