A needs comparison of justice-involved Iraq/Afghanistan veterans to other service eras

Abstract

s / Drug and Alcohol Dependence 146 (2015) e34–e117 e55 evaluated by randomly assigning parolees to 6monthly naltrexone injections or treatment as usual (TAU) without medication. Methods: All patients met DSM-IV criteria for opioid dependence. 308 parolees were randomized and 290 are now eligible for 6-month follow up. The naltrexone group received 6 monthly injections of 380mg and amonthly visit with a nurse. The parolees randomized to TAU received help in joining a community counseling program. Outcomes were measured by urine tests and self-report. Results: Retention rates in treatment at 27, 52, and 78 weeks were 64%, 58% and 54% for the TAU group and 66%, 54% and 52% for the naltrexone group. Urine tests were examined at 27, 52 and 78 weeks andwithpooleddata fromall 5 sites, therewere significantly fewer opioid positive urines in the naltrexone group (p< .0001 for the pooled analysis). The rate of positive opioids for TAU was 3.36 times higher than that for naltrexone. No significant differencewas found for other drugs. There were 2 opioid overdoses in the TAU group and none in the naltrexone group. There were 4 deaths from all causes in the TAU group and 2 deaths in the naltrexone group unrelated to medication. Conclusions: A monthly injection of depot naltrexone significantly reduced opioid relapse in parolees. Six-month retentionwas similar in the two groups. Serious adverse events including opioid overdose occurred less often in the group receiving naltrexone (18 naltrexone vs. 43 for TAU). In this interim analysis, depot naltrexone was found to be both safe and effective in reducing the rate of relapse to opioid use. Financial support: This research was supported by collaborative RO-1 grants to the 5 sites involved. The extended release naltrexone in the form of Vivitrol was supplied by Alkermes Inc. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.519 A needs comparison of justice-involved Iraq/Afghanistan veterans to other service eras Kathryn O’Connor1,2, Debra A. Pinals3,1, David Smelson1,2, Leon Sawh2,4,1, Carl Fulwiler1, Stephanie Singer1, William Fisher4, Stephanie Hartwell5, Gerardo Gonzalez1 1 University of Massachusetts Medical School, Worcester, MA, United States 2 US Department of Veterans Affairs, Bedford, MA, United States 3 Massachusetts Department of Mental Health, Boston, MA, United States 4 University of Massachusetts, Lowell, Lowell, MA, United States 5 University of Massachusetts, Boston, Boston, MA,