Then sterilizing the ingredient (which isn't always easy), and formulating a product that is very slow release. Not exactly easy. I give credit to the company for coming up with a useful slow release formulation of a product where nobody else did. Not just a re-hash/evergreening of an existing product for the sake of patent extension (oral Flomax CR, what was the point???)

My bigger concern is with naltrexone itself: If individuals on this need any dental/medical procedure, or have an accident, anaesthesia is very atypical. On-scene EMS won't be able to provide pain management beyond an ibuprofen.

Something like non-opioids that aren't typically used (ketamine, nitrous oxide, other volatile anaesthetics) or sufficiently high doses of short-acting opioids (fentanyl derivative) to overcome the naltrexone blockade (which would need active anaesthesiologist .management)