{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:08:27Z","timestamp":1777378107077,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2003,4,1]],"date-time":"2003-04-01T00:00:00Z","timestamp":1049155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2003,4]]},"abstract":"<jats:p>Doctors are at an increased risk for prescription drug use, particularly opioids and benzodiazpines. This use can interfere with work function and has major potential negative implications for patient safety. Oral naltrexone, an opioid antagonist, has been used as part of a management strategy for opioid-dependent physicians. While some patients stabilize on oral naltrexone, others relapse to opioid use. An alternative method of naltrexone maintenance involves the injection or surgical insertion of a sustained release preparation of naltrexone. This approach dramatically improves compliance, removing the onus from the previously opioid impaired physician to use daily oral naltrexone.<\/jats:p>\n                  <jats:p>This article describes the cases of four opioid-impaired doctors who received naltrexone (either oral or implant) as part of their management. The authors conclude that monitoring daily oral naltrexone use and detecting early opioid relapse is difficult, placing both the opioid impaired physician and their patients at risk. In contrast, by using implantable naltrexone, compliance is assured and opioid abstinence can virtually be guaranteed for five months. It is argued that naltrexone implants offer a level of protection not achieved with any previous treatment. It is recommended that management should involve early and close collaboration between the treating doctor and the Medical Board, with initial treatment, ongoing monitoring and follow-up being a Medical Board requirement for registration.<\/jats:p>","DOI":"10.1177\/0310057x0303100211","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T21:20:34Z","timestamp":1548192034000},"page":"196-201","source":"Crossref","is-referenced-by-count":15,"title":["Use of Oral and Implantable Naltrexone in the Management of the Opioid-Impaired Physician"],"prefix":"10.1177","volume":"31","author":[{"given":"G. K.","family":"Hulse","sequence":"first","affiliation":[{"name":"School of Psychiatry and Clinical Neurosciences, University of Western Australia, QE II Medical Centre."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"O'Neil","sequence":"additional","affiliation":[{"name":", Obstetrician, School of Psychiatry and Clinical Neurosciences, University of Western Australia, QE II Medical Centre and The Australian Medical Procedures Research Foundation."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Hatton","sequence":"additional","affiliation":[{"name":", Psychiatrist, The Australian Medical Procedures Research Foundation."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. J.","family":"Paech","sequence":"additional","affiliation":[{"name":", Clinical Associate Professor, Department of Anaesthesia and Pain Management, King Edward Memorial Hospital for Women and Department of Pharmacology, University of Western Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2003,4,1]]},"reference":[{"key":"bibr1-0310057X0303100211","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03370140111034"},{"key":"bibr2-0310057X0303100211","first-page":"233","volume":"91","author":"Bohigian G.","year":"1994","journal-title":"Modern Medicine"},{"key":"bibr3-0310057X0303100211","first-page":"402","volume":"86","author":"Single E.","year":"1995","journal-title":"Can J Public Health"},{"key":"bibr4-0310057X0303100211","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb123721.x"},{"key":"bibr5-0310057X0303100211","doi-asserted-by":"publisher","DOI":"10.1080\/09652149640419"},{"key":"bibr6-0310057X0303100211","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(05)70562-9"},{"key":"bibr7-0310057X0303100211","first-page":"192","volume":"17","author":"Quinn W.","year":"1968","journal-title":"New Physician"},{"key":"bibr8-0310057X0303100211","first-page":"5","volume-title":"Narcotic Antagonists: Naltrexone, NIDA Research Monograph No: 9,","author":"Julius D.","year":"1976"},{"key":"bibr9-0310057X0303100211","first-page":"46","volume":"45","author":"Ling W.","year":"1984","journal-title":"J Clin Psych"},{"issue":"9","key":"bibr10-0310057X0303100211","first-page":"39","volume":"45","author":"Washton A.M.","year":"1984","journal-title":"J Clin Psych"},{"issue":"9","key":"bibr11-0310057X0303100211","first-page":"4","volume":"45","author":"Ginzburg H.M.","year":"1984","journal-title":"J Clin Psych"},{"key":"bibr12-0310057X0303100211","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(96)00164-X"},{"key":"bibr13-0310057X0303100211","unstructured":"HulseG.K., Arnold-ReedD.E., HanssonR., O'NeilG., ChanC. Blood naltrexone and 6-naltrexol levels following double or single naltrexone implant insertion, Abstracts: 7th International Stapleford Conference on Addiction Management, Nijmegen, Netherlands 2002."}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X0303100211","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X0303100211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:10:05Z","timestamp":1777367405000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X0303100211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,4]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2003,4]]}},"alternative-id":["10.1177\/0310057X0303100211"],"URL":"https:\/\/doi.org\/10.1177\/0310057x0303100211","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,4]]}}}