THE NASSAU COUNTY DEPARTMENT OF DRUG AND ALCOHOL ADDICTION ADMINISTERS JOINT ANTAGONIST PROGRAMS UNDER A COMPREHENSIVE PROCESS COMBINING CONCEPTS OF DIVERSION AND REHABILITATION THROUGH THE PREVENTION OF CRIME CAUSES WITH MEDICAL TREATMENT. TWO SUCH PROGRAMS ARE A NARCOTIC ANTAGONIST WORK RELEASE PROGRAM (INSTITUTIONAL) AND AN ANTAGONIST TREATMENT CLINIC (OUTPATIENT). PATIENTS IN THE WORK RELEASE PROGRAM ARE INMATES FROM A MAXIMUM SECURITY CORRECTIONAL FACILITY WHO HAVE REQUESTED THE PRIVILEGE OF WORK RELEASE. BEFORE ADMISSION TO THE PROGRAM, A COMPLETE HISTORY IS OBTAINED, A PHYSICAL EXAMINATION IS GIVEN, LABORATORY TESTS ARE PERFORMED, AND PSYCHIATRIC EVALUATION AND PSYCHOLOGICAL TESTING FOR BASELINE DATA AND TREATMENT PLANNING ARE CONDUCTED. PATIENT CARE PROCEDURES INVOLVE NALTREXONE INDUCTION FOR DETOXIFICATION, DAILY MEDICAL ADMINISTRATION, AND NONPHARMACOLOGICAL SUPPORT (GROUP AND INDIVIDUAL COUNSELING, VOCATIONAL AND EDUCATIONAL SERVICES, AND COMMUNITY ADJUSTMENT). PATIENTS TREATED AT THE OUTPATIENT CLINIC ARE PERSONS WITH LEGAL RESTRICTIONS MANDATED BY PROBATION OR PAROLE, OTHER AGENCY REFERRALS, AND STREET REFERRALS. ADMISSION PROCEDURES ARE SIMILAR TO THOSE FOR THE WORK RELEASE PROGRAM. PATIENT CARE PROCEDURES INCLUDE OPIATE DETOXIFICATION AND NALTREXONE INDUCTION, AS WELL AS MEDICAL ADMINISTRATION AND NONPHARMACOLOGICAL SUPPORT. PRACTICAL EXPERIENCE WITH NALTREXONE TREATMENT INDICATES THAT IT IS A RELATIVELY SAFE ANTAGONIST. THREE PRIMARY ADVANTAGES OF THE NALTREXONE METHOD OF DETOXIFICATION ARE: (1) ONLY 1 OR 2 DAYS ARE LOST FROM A PATIENT'S REGULAR ACTIVITIES, IN CONTRAST TO THE LENGTHLY PROCESS OF INSTITUTIONAL DETOXIFICATION; (2) DISCOMFORT OF WITHDRAWAL IS MINIMIZED; AND (3) MONETARY SAVINGS ARE SIGNIFICANT IN COMPARISON WITH INSTITUTIONAL DETOXIFICATION. REFERENCES ARE INCLUDED. (DEP)