Availability of Extended-Release Naltrexone May Increase the Number of Opioid-Dependent Individuals in Treatment: Extension of a Randomized Clinical Trial.


Journal

European addiction research
ISSN: 1421-9891
Titre abrégé: Eur Addict Res
Pays: Switzerland
ID NLM: 9502920

Informations de publication

Date de publication:
2019
Historique:
received: 18 02 2019
accepted: 04 07 2019
pubmed: 25 7 2019
medline: 31 3 2020
entrez: 25 7 2019
Statut: ppublish

Résumé

Opioid maintenance treatment (OMT) is highly available in Norway, but only 50% of opioid-dependent individuals are enrolled in such programs. This study was aimed at examining if availability of extended-release naltrexone (XR-NTX) could attract individuals who for different reasons were not enrolled in an OMT program. In a Norwegian clinical study, n = 117 opioid-dependent adults volunteered to receive XR-NTX in a 9-month period, as an extension of a previous randomized clinical trial. Before study inclusion, 40.2% (n = 47) of the study participants were not enrolled in OMT while the remainder were recruited from OMT. Participants not enrolled in OMT displayed more ongoing severe addiction-related problems such as heroin use (p = 0.002), but displayed a higher retention in treatment in the 9-month extension study (p = 0.048 for log-rank test) than participants enrolled in OMT. Availability of XR-NTX attracted opioid-dependent individuals not previously enrolled in OMT. While OMT may be perceived as a burden with regard to daily intake and control measures, one-monthly injections with XR-NTX may be perceived favourable, offering more freedom to the patients, not having addictive properties, and potentially reducing heroin craving. We suggest that an introduction of XR-NTX in Europe may increase the number of opioid-dependent individuals in treatment.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Opioid maintenance treatment (OMT) is highly available in Norway, but only 50% of opioid-dependent individuals are enrolled in such programs. This study was aimed at examining if availability of extended-release naltrexone (XR-NTX) could attract individuals who for different reasons were not enrolled in an OMT program.
METHODS METHODS
In a Norwegian clinical study, n = 117 opioid-dependent adults volunteered to receive XR-NTX in a 9-month period, as an extension of a previous randomized clinical trial.
RESULTS RESULTS
Before study inclusion, 40.2% (n = 47) of the study participants were not enrolled in OMT while the remainder were recruited from OMT. Participants not enrolled in OMT displayed more ongoing severe addiction-related problems such as heroin use (p = 0.002), but displayed a higher retention in treatment in the 9-month extension study (p = 0.048 for log-rank test) than participants enrolled in OMT.
CONCLUSION CONCLUSIONS
Availability of XR-NTX attracted opioid-dependent individuals not previously enrolled in OMT. While OMT may be perceived as a burden with regard to daily intake and control measures, one-monthly injections with XR-NTX may be perceived favourable, offering more freedom to the patients, not having addictive properties, and potentially reducing heroin craving. We suggest that an introduction of XR-NTX in Europe may increase the number of opioid-dependent individuals in treatment.

Identifiants

pubmed: 31340204
pii: 000501931
doi: 10.1159/000501931
doi:

Substances chimiques

Delayed-Action Preparations 0
Narcotic Antagonists 0
Naltrexone 5S6W795CQM

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

303-309

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Kristin Klemmetsby Solli (KK)

Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway, k.k.solli@medisin.uio.no.
Department of R&D in Mental Health, Akershus University Hospital, Loerenskog, Norway, k.k.solli@medisin.uio.no.
Vestfold Hospital Trust, Toensberg, Norway, k.k.solli@medisin.uio.no.

Nikolaj Kunoe (N)

Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.

Zill-E-Huma Latif (ZE)

Department of R&D in Mental Health, Akershus University Hospital, Loerenskog, Norway.

Kamni Sharma-Haase (K)

Vestfold Hospital Trust, Toensberg, Norway.

Arild Opheim (A)

Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
The University of Bergen, Bergen, Norway.

Peter Krajci (P)

Department of Addiction Medicine, Oslo University Hospital, Oslo, Norway.

Zhanna Gaulen (Z)

Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
The University of Bergen, Bergen, Norway.

Jūratė Šaltytė Benth (J)

Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.
Health Services Research Unit, Akershus University Hospital, Loerenskog, Norway.

Lars Tanum (L)

Department of R&D in Mental Health, Akershus University Hospital, Loerenskog, Norway.
Oslo Metropolitan University, Oslo, Norway.

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Classifications MeSH