Abstract
Three persons who were regularly taking methadone, heroin, or both, ingested 50 to 188 mg of naltrexone, a potent narcotic antagonist. Each experienced an acute narcotic withdrawal syndrome beginning within 5 minutes of ingestion and lasting up to 48 hours. Mental status changes including confusion and somnolence were noted in two patients, one of whom also experienced visual hallucinations. Significant fluid loss through vomiting and diarrhea, which required intravenous fluid replacement, occurred in the same two patients. Illicit dissemination of naltrexone poses another hazard for opiate addicts.
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