Pellet Program
A pure narcotic antagonist (naltrexone) is inserted under the skin of the patient. Detoxification
and naltrexone maintenance therapy is not a cure for addiction. Naltrexone maintenance therapy
is a crutch to be used in early recovery. The maintenance of abstinence is best achieved through
participation in a 12-step recovery program. Studies have shown that the best indicator of
long-term recovery is continued participation in a 12-step recovery program. The period of
abstinence during which naltrexone is used leads to a loss of tolerance to the effects of
opiates. A patient utilizing naltrexone needs to be aware that when the naltrexone pellet
wears off and there is a return to using the same dose of opiates that he had previously
used, the patient may kill himself.
After an area is anesthetized with 2% Lidocaine with epinephrine, it is prepared and draped in
the usual manner. An incision is made with a #15 blade, approximately one-half inch in length.
A pocket is created in the area adjacent to the incision by blunt dissection with blunt curved
Metzenbaum scissors. A 1-gram naltrexone pellet is inserted into the pocket and the wound is
closed with 2 simple interrupted sutures of #3-0 Vicryl and the wound is dressed.
Should the patient be injured after the procedure and require analgesia (pain medications),
he must inform the doctor that he is on naltrexone maintenance therapy so that the proper
medications may be prescribed. Because the patient may be involved in an accident or some
other occurrence that renders him unable to inform the doctor that he is on the medication,
it is recommended that he wear a Medic-Alert tag which advises the doctor that the patient
is receiving naltrexone maintenance therapy.
The patient must be aware that following implantation of the pellet, the following symptoms
might signify wound infection: Tenderness, redness, swelling and warmth at the site of the
insertion of the naltrexone. If the patient notices the development of these changes, contact
the physician's office so that a prescription for an antibiotic may be called in to the pharmacist.
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