Factors Associated With ER-Naltrexone Treatment Success

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Patients were evaluated monthly at the time of their visit to receive naltrexone injections and for another 6 months after treatment discontinuation.
Patients were evaluated monthly at the time of their visit to receive naltrexone injections and for another 6 months after treatment discontinuation.

Mental health, education level, and recent drug use may be associated with the duration of treatment with extended-release naltrexone (XR-NTX) for opioid dependence, according to a study published in Addiction.

A total of 395 patients from 32 treatment centers receiving XR-NTX for opioid dependence were enrolled in an observational registry in which their demographic data and baseline clinical and psychiatric information was entered.

Patients were evaluated monthly at the time of their visit to receive XR-NTX injections and for another 6 months after treatment discontinuation.

During these visits, participants were examined and completed questionnaires to assess their functioning, craving, health, and quality of life. Subgroups were based on the number of injections received during the 6-month study period (1 injection, n=132; 2 to 3 injections, n=152; and 6 injections, n=111).

Patients received an average of 5 injections (median, 3; range, 1 to 25). The median number of XR-NTX injections received was found to be higher in patients who were employed vs unemployed at baseline (3 vs 2, respectively; P =.02) and in patients who had private insurance vs self- or state-funded payment (private insurance, median, 5 injections; self-funded, 2 injections; state-funded, 2 injections; P =.005 and P <.001, respectively).

Patients receiving the maximum of 6 XR-NTX injections were found to be more likely to attend school, less likely to report recent drug use, and more likely to present with normal mental health to minimal mental illness.

Study participants who had received 6 injections during the 6-month study period indicated reduced opioid craving, drug use, and drug-related behavior, as well as improvements in employment, mental health, and psychosocial functioning compared with the other subgroups.

The observational nature and the lack of a control arm represent study limitations.

“[These results] support the continued use of XR-NTX and may help health-care providers to identify patients who will benefit from XR-NTX treatment,” concluded the study authors.

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Reference

Saxon AJ, Akerman SC, Liu CC, et al. Extended-release naltrexone (XR-NTX) for opioid use disorder in clinical practice: Vivitrol's Cost and Treatment Outcomes Registry [published online March 1, 2018]. Addiction. doi:10.1111/add.14199

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