{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:08:07Z","timestamp":1789978087111,"version":"4.0.1"},"reference-count":49,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100008487","name":"Sosiaali- ja Terveysministeri\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008487","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,6,21]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>There is growing interest in the use of medication-assisted treatments for gambling disorder (GD). Opioid receptor antagonists are hypothesised to blunt the craving associated with gambling. This study was designed to assess the feasibility of using an intranasal naloxone spray to treat GD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An 8-week, open-label, uncontrolled pilot study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single study site in the capital region of Finland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Twenty problem gamblers (nine men) were randomised into two groups. Group A (n=10) took one dose into one nostril (2\u2009mg naloxone), as needed, with a maximum of 4 doses\/day (max. 8\u2009mg\/day). Group B (n=10) took one dose into each nostril (4\u2009mg naloxone) as needed, with a maximum of 4 doses\/day (max. 16\u2009mg\/day).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Naloxone hydrochloride nasal spray.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Acceptability and feasibility of the intervention were assessed. Use of study medication, adverse events, gambling frequency and gambling expenditure were recorded in a mobile diary. Problem gambling: South Oaks Gambling Screen (SOGS), depressive symptoms: Beck Depression Inventory (BDI) and alcohol use: Alcohol Use Disorders Identification Test were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study completion rate was 90%. Acceptability and feasibility scores were high. Group B used intranasal naloxone more frequently than group A, and consequently used more naloxone. No serious adverse events were reported. The postintervention SOGS scores were lower (median=4 (IQR=3.75) versus preintervention scores (median=12 (IQR=4.75)). Depressive symptoms were reduced during the trial (preintervention BDI median=9, IQR=9\u2009vs postintervention BDI median=6, IQR=6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The acceptability and feasibility of using intranasal naloxone were high, and no serious adverse events were reported. Preliminary results suggest mixed results in terms of gambling behaviour (ie, reduced frequency but not expenditure) and decreased depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>EudraCT2016-001828-56<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023728","type":"journal-article","created":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T05:18:18Z","timestamp":1566451098000},"page":"e023728","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Treating gambling disorder with as needed administration of intranasal naloxone: a pilot study to evaluate acceptability, feasibility and outcomes"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03430180","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-9610","authenticated-orcid":false,"given":"Sari","family":"Castr\u00e9n","sequence":"first","affiliation":[{"name":"Department of Public Health Solutions, Terveyden ja hyvinvoinnin laitos, Helsinki, Finland"},{"name":"Faculty of Social Science, Department of Psychology and Speech Language Pathology, Turun Yliopisto, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"M\u00e4kel\u00e4","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Addictions Unit, Terveyden ja hyvinvoinnin laitos, Helsinki, Finland"},{"name":"Clinicum, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Haikola","sequence":"additional","affiliation":[{"name":"Faculty of Natural Sciences, University of Tampere, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne H","family":"Salonen","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Addictions Unit, Terveyden ja hyvinvoinnin laitos, Helsinki, Finland"},{"name":"Ita-Suomen yliopisto Terveystieteiden tiedekunta, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Crystal","sequence":"additional","affiliation":[{"name":"Opiant Pharmaceuticals, Santa Monica, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Scheinin","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannu","family":"Alho","sequence":"additional","affiliation":[{"name":"Alcohol, Drugs and Addictions Unit, Terveyden ja hyvinvoinnin laitos, Helsinki, Finland"},{"name":"Abdominal Center, University and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,21]]},"reference":[{"key":"2025121404335674000_9.8.e023728.1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. 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