The naltrexone implants aren't popular here for the same reason they're not popular in other countries...they're extremely expensive and they're easier and more practical ways to take naltrexone for most people. Many people that are opiate addicts are legitimate chronic pain patients with health problems. Because the implant is permanent for a year, it has to be surgically removed if someone needs opiates for any reason or surgery. It's easier for someone to take the pills, have their intake tested to keep up with compliance, and have the option to stop if needed. It's this same reason that the Vivitrol injections aren't as popular as well. Also, the cost is prohibitive for most. 3-5 thousand dollars is a lot of money that many would rather put towards traditional rehab and not have to depend on a chemical solution. Plus, the pills can be used if necessary. Naltrexone has it's place, especially for people that are continually non-compliant...but, it's one of those options that's more of a last resort than a front line defense. Even a naltrexone implant isn't foolproof however as I've seen people literally dig the implant from under their skin to get their fix.
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