Opioid antagonists. II: Clinical effects in the treatment of self-injury in individuals with developmental disabilities

Two hypotheses have been proposed linking dysfunctions of the endogenous endorphin system with the origin and maintenance of self-injury in some individuals. This has spurred interest in the use of opioid antagonists, most commonly naloxone and naltrexone, to treat self-injury. Although many of the studies have reported positive findings, these data must be interpreted wit caution because the majority of the studies were typically anecdotal case reports or were methodologically flawed. We present a clinical and methodological review of the research on the efficacy of both naloxone and naltrexone in the treatment of self-injury in individuals with developmental disabilities. Taken in their best light, seven of nine studies using naloxone showed a positive effect on self-injury and 16 of 18 studies using naltrexone showed a positive effect. The implications of these data are discussed in terms of future research.