Long-term follow-up study of community-based patients receiving XR-NTX for opioid use disorders.

Abstract

BACKGROUND AND OBJECTIVES:

Extended-release naltrexone (XR-NTX) is FDA-approved to prevent relapse in patients with Opioid Use Disorder. However little is known about long-term use among community-based outpatients.

METHODS:

Retrospective chart review and long-term follow-up survey among individuals (N = 168) who entered an outpatient XR-NTX trial between 2011 and 2015, during which participants were offered three monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of four domains: (1) substance use; (2) treatment continuation; (3) barriers; and (4) attitudes.

RESULTS:

Fifty-seven respondents were successfully surveyed, including 50% of those initially receiving all three XR-NTX injections ("study completers") in the parent study. Study completion was associated with superior outcomes and less likely relapse (defined as daily use), with a much greater time to relapse despite higher rates of concurrent non-opioid substance use. However the majority of participants discontinued treatment with XR-NTX at study completion, largely due to attitudes of "feeling cured" and "wanting to do it on my own" rather than external barriers such as cost or side effects.

CONCLUSION:

Patients who initiate treatment with XR-NTX might benefit from anticipatory guidance and motivational techniques to encourage long-term adherence as many will experience internal barriers to continuation. Our findings are reassuring that few patients experience side effects or adverse events complicating the effectiveness or safety of long-term use of XR-NTX.

SCIENTIFIC SIGNIFICANCE:

Among outpatients who successfully receive 3 monthly XR-NTX injections, many will prematurely discontinue treatment due to internal attitudes, such as "feeling cured." (Am J Addict 2017;26:319-325).

• Authors: Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R Levin, Edward V Nunes, John J Mariani, Adam Bisaga
• Journal: The American journal on addictions (Am J Addict) Vol. 26 Issue 4 Pg. 319-325 (Jun 2017) ISSN: 1521-0391 [Electronic] England
• PMID: 28328148 (Publication Type: Journal Article)
• Copyright: © 2017 American Academy of Addiction Psychiatry.

Chemical References

• Delayed-Action Preparations
• Narcotic Antagonists
• Naltrexone

Topics

• Adolescent
• Adult
• Delayed-Action Preparations
• Female
• Follow-Up Studies
• Health Knowledge, Attitudes, Practice
• Humans
• Male
• Medication Adherence (psychology)
• Middle Aged
• Naltrexone (therapeutic use)
• Narcotic Antagonists (therapeutic use)
• Opioid-Related Disorders (drug therapy, psychology)
• Outpatients
• Young Adult