Compressed opiate withdrawal syndrome and naltrexone

The oral opiate antagonist naltrexone is in regular use in clinical practice with abstinent opiate-dependent individuals. Acute opioid withdrawal is a well-recognised consequence of consuming naltrexone while opiate dependent. Two cases of naltrexone-induced opiate withdrawal are reported. The compressed nature of the withdrawal syndrome in both of these cases and the implications for the management of protracted withdrawal symptoms are discussed. The theoretical implications of this experimental and clinical phenomenon are reviewed.