What's the reasoning of limiting the time using very Low Dose Naltrexone (VLDN) or Ultra Low Dose Naltrexone ULDN, with short-acting opiates? 

What's the reasoning of limiting the time using very Low Dose Naltrexone (VLDN) or Ultra Low Dose Naltrexone ULDN, with short-acting opiates? 

Beyond the obvious value of getting patients opiate free, what's the reasoning of limiting the time using VLDN, ULDN, with short-acting opiates rather than keeping them on long-term? I successfully weaned myself off high-dose fentanyl patches years ago. My conditions are more complicated now, and being opiate free seems unreachable today. My goal has been short-acting opiates during the day and ULDN, VLDN at night. 

So anytime we're using very low dose or ultra low dose, the Oxytrex study did show that one microgram of Ultra Low Dose Naltrexone with five milligrams of Oxycodone was helpful in a patient population to work synergistically with the Oxycodone. 

That doesn't mean that that's the way it's going to work for everybody. So whether we're using ultra low dose or very low dose, if someone is on even short-acting opiates, we could have opiate receptor blockade from the Naltrexone, where the opiates or the pain medications are not going to work. 

The long-acting Opiates, that's even more of a situation. Fentanyl patches or other pain patches that are pain medications, again, that could be a significant issue. So you literally may not be pain free, or the Opiate medications may not work as well, having even Very Low Dose or Ultra Low Dose Naltrexone on board.