Cessation of long-term naltrexone administration: longitudinal follow-ups.

Garcia et al. (1999) tracked one adult with profound intellectual disability for four years after he stopped taking naltrexone. The team wanted to see if his self-injury would return once the drug was gone. They watched him through staff changes, new homes, and different routines.

The man kept self-injury near zero for the whole four years. The behavior did not come back even when caregivers or settings changed. This suggests the drug may have broken the cycle for good, not just paused it.

Tantam et al. (1993) saw the same thing six years earlier: one adult stayed almost injury-free for six months after stopping naltrexone. Together, the two cases hint at a lasting effect.

Green et al. (1987) looks like a contradiction. They gave naltrexone to two adults and saw no drop in self-injury during the drug phase. The difference is timing: L measured during treatment, while D measured years after stopping. The drug may work as a reset, not a daily shield.

Taub et al. (1994) show another long win. They used brief electric shock instead of drugs and also kept self-injury low for six years after the intervention ended. Both studies prove that, with the right setup, some severe behaviors can stay gone even after the main tool is removed.

If you have a client whose self-injury fades after naltrexone, do not panic when the prescription ends. Track the behavior for months or years. Use the calm period to teach replacement skills and solidify routines. The drug may have opened a window; your teaching keeps it open.