Naltrexone For Opioid Dependence Research Articles

Correcting misclassification of overdose events in a randomised trial comparing buprenorphine and naltrexone for opioid dependence

Correcting misclassification of overdose events in a randomised trial comparing buprenorphine and naltrexone for opioid dependence

Effectiveness, safety and feasibility of extended-release naltrexone for opioid dependence: a 9-month follow-up to a 3-month randomized trial.

This is a follow-up study of a previously published randomized clinical trial conducted in Norway that compared extended-release naltrexone (XR-NTX) to buprenorphine-naloxone (BP-NLX) over 3months. At the conclusion of the trial, participants were offered their choice of study medication for an additional 9months. While BP-NLX was available at no cost through opioid maintenance treatment programmes, XR-NTX was available only through study participation, accounting for why almost all participants chose XR-NTX in the follow-up. The aim of this follow-up study was to compare differences in outcome between adults with opioid dependence continuing XR-NTX and those inducted on XR-NTX for a 9-month period, on measures of effectiveness, safety and feasibility. In this prospective cohort study, participants were either continuing XR-NTX, changed from BP-NLX to XR-NTX or re-included into the study and inducted on XR-NTX treatment. Five urban, out-patient addiction clinics in Norway. Opioid-dependent adults continuing (n=54) or inducted on (n=63) XR-NTX. XR-NTX administrated as intramuscular injections (380mg) every fourth week. Data on retention, use of heroin and other illicit substances, opioid craving, treatment satisfaction, addiction-related problems and adverse events were reported every fourth week. Nine-month follow-up completion rates were 51.9% among participants continuing XR-NTX in the follow-up and 47.6% among those inducted on XR-NTX. Opioid abstinence rates were, respectively, 53.7 and 44.4%. No significant group differences were found in use of heroin and other opioids. Opioid-dependent individuals who elect to switch from buprenorphine-naltrexone treatment after 3months to extended-release naltrexone treatment for 9months appear to experience similar treatment completion and abstinence rates and similar adverse event profiles to individuals who had been on extended-release naltrexone from the start of treatment.

An open label naturalistic study of predictors of retention and compliance to naltrexone maintenance treatment among patients with opioid dependence

Background: This study aimed at assessment of retention and compliance to naltrexone for long-term management among patients with opioid dependence syndrome over a follow-up period of 15 months. Additionally, it aimed to identify predictors of retention in naltrexone treatment.Methods: The study was conducted at a tertiary care drug dependence treatment centre. The study involved patients with opioid dependence syndrome who were prescribed naltrexone for long-term management. Information was collected for socio-demographic variables, drug use history, diagnosis, retention and compliance to naltrexone treatment. Data were analysed using SPSS ver 21 (IBM Inc., New York, NY).Results: One hundred fifty-three patients were enrolled in naltrexone maintenance treatment following an initial detoxification phase. Duration of retention was longer among those who did not report concurrent use of cannabis (z = 2.06, p = 0.03) or benzodiazepines (z = 2.04, p = 0.04) at the time of presentation to treatment centre. Marital status (OR 3.61, 95% CI 0.96–8.22), employment status (OR 8.18, 95% CI 1.68–16.53), age at onset of opioid use (OR 13.17, 95% CI 1.08–1.31), duration of opioid use (OR 11.56, 95% CI 0.97–0.99) and number of abstinence attempts in past (OR 7.49, CI 1.20–3.07) as predictors of retention at 90 days (Table 4). Similarly, marital status (OR 4.80, 95% CI 1.13–10.22), employment status (OR 4.90, 95% CI 1.20–21.61), duration of opioid use (OR 8.11, 95% CI 0.96–0.99) and number of abstinence attempts in past (OR 8.18, 95% CI 1.23–3.05) were predictors of retention at 180 days.Conclusions: Certain socio-demographic and drug use related variables are predictors of longer retention in naltrexone treatment. These factors can guide the selection process for the patients suited for long-term maintenance with naltrexone for opioid dependence.

REMOVED: Sustained-release naltrexone for opioid dependence: A cochrane review and meta-analysis

REMOVED: Sustained-release naltrexone for opioid dependence: A cochrane review and meta-analysis

Dissemination of evidence‐based practices: how far we've come, and how much further we've got to go

Dissemination of evidence‐based practices: how far we've come, and how much further we've got to go

Efficacy of maintenance treatment with naltrexone for opioid dependence: a meta‐analytical review

To determine the efficacy of naltrexone in reducing illicit opioid use and the potential moderating role of treatment retention. First, randomized controlled trials (RCTs) comparing the regimens of treatment using the opioid antagonist, naltrexone, with controls were analysed by meta-analysis for treatment effect with regard to a range of outcome criteria. The degree of heterogeneity was also determined. The moderating effect of other interventions during naltrexone maintenance was then estimated, particularly with regard to their effect on treatment retention. Fifteen studies involving 1,071 patients were found. All available outcomes were analysed in 10 studies of naltrexone versus control (seven placebo) and six studies of randomized psychosocial/psychopharmacological interventions. Significant heterogeneity was found in the efficacy of naltrexone. Level of retention in treatment was found to be a moderator, explaining most of the heterogeneity found. Overall, naltrexone was significantly better than control conditions in reducing the number of opioid-positive urines. This effect was only present in the high retention subgroup for differences in retention. Contingency management (CM) increased retention and naltrexone use, resulting in a reduced number of opioid-positive urines. Retention is important to the effect of naltrexone in treating opioid dependence. Contingency management is a promising method of increasing retention.

Naltrexone for opioid dependence: evaluation of a manualized psychosocial protocol to enhance treatment response

Naltrexone for opioid dependence: evaluation of a manualized psychosocial protocol to enhance treatment response