…conducting an RCT (randomized controlled trial) comparing two medical treatments (depot naltrexone and methadone.) misses the critical issue—that cure of addiction is not through medical interventions. People need social roles that provide identity other than being an addict and provide alternative rewards to drug use, in order to recover from addiction. Medical treatment cannot provide this.
…Lacking the rewards of social role and affiliation with social structures—primarily employment—an individual’s capacity to recover from drug dependence is restricted. A clear-sighted acknowledgement of what treatment can reasonably be expected to achieve is essential before pinning unrealistic hopes on new treatment options. The most likely outcome of further experience and research will be to confirm that, like methadone and buprenorphine, depot naltrexone will be helpful for some people during some periods of their addiction.—James Bell in the journal Addiction (Pay-walled)