Treating opioid dependence with extended-release naltrexone (XR-NTX) in Ukraine: Feasibility and three-month outcomes.
Extended-release naltrexone
Opioid dependence
Retention
Ukraine
Journal
Journal of substance abuse treatment
ISSN: 1873-6483
Titre abrégé: J Subst Abuse Treat
Pays: United States
ID NLM: 8500909
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
04
12
2018
revised:
11
04
2019
accepted:
08
05
2019
entrez:
3
8
2019
pubmed:
3
8
2019
medline:
25
8
2020
Statut:
ppublish
Résumé
Although opioid agonist treatments (OAT) with methadone or buprenorphine are available to treat opioid use disorders (OUD) in Ukraine, OAT acceptability and coverage remains low. Extended-release naltrexone (XR-NTX) that recently became available as another treatment option provides new opportunities for treating OUDs in this region and we aimed to test its feasibility. Patients with OUD (N=135) and interested in treatment with XR-NTX were initiated on monthly XR-NTX injections and monitored for three months. Correlates of 3-month retention on XR-NTX and drug use at each time-point using self-reports and urine drug testing (UDT) were assessed. Of the 134 participants initiated XR-NTX, 101 (75%) completed three months, defined as 4 consecutive XR-NTX injections. Independent factors negatively associated with retention in XR-NTX treatment included previous maintenance with OAT (aOR=0.3; 95%CI=0.1-0.9) and extrinsic help-seeking treatment motivation (aOR=0.7; 95%CI=0.5-0.9). Of these 101 participants completing three months of treatment, opioid use markedly reduced using self-report (67%% to 22%; p>0.001) and UDT (77% to 24%; p<0.001) outcomes over time. Alcohol, marijuana and stimulant use, however, remained unchanged. Craving for opioids and symptoms of depression also significantly decreased, while health-related quality of life scores improved over time. No adverse side effects were reported during the period of observation. The first introduction of XR-NTX in Ukraine among persons with OUD resulted in high levels of retention, marked reductions in opioid use and improved quality of life. These descriptive results suggest that XR-NTX treatment is feasible and well-tolerated over a 3-month period in Ukraine.
Sections du résumé
BACKGROUND
Although opioid agonist treatments (OAT) with methadone or buprenorphine are available to treat opioid use disorders (OUD) in Ukraine, OAT acceptability and coverage remains low. Extended-release naltrexone (XR-NTX) that recently became available as another treatment option provides new opportunities for treating OUDs in this region and we aimed to test its feasibility.
METHODS
Patients with OUD (N=135) and interested in treatment with XR-NTX were initiated on monthly XR-NTX injections and monitored for three months. Correlates of 3-month retention on XR-NTX and drug use at each time-point using self-reports and urine drug testing (UDT) were assessed.
RESULTS
Of the 134 participants initiated XR-NTX, 101 (75%) completed three months, defined as 4 consecutive XR-NTX injections. Independent factors negatively associated with retention in XR-NTX treatment included previous maintenance with OAT (aOR=0.3; 95%CI=0.1-0.9) and extrinsic help-seeking treatment motivation (aOR=0.7; 95%CI=0.5-0.9). Of these 101 participants completing three months of treatment, opioid use markedly reduced using self-report (67%% to 22%; p>0.001) and UDT (77% to 24%; p<0.001) outcomes over time. Alcohol, marijuana and stimulant use, however, remained unchanged. Craving for opioids and symptoms of depression also significantly decreased, while health-related quality of life scores improved over time. No adverse side effects were reported during the period of observation.
CONCLUSION
The first introduction of XR-NTX in Ukraine among persons with OUD resulted in high levels of retention, marked reductions in opioid use and improved quality of life. These descriptive results suggest that XR-NTX treatment is feasible and well-tolerated over a 3-month period in Ukraine.
Identifiants
pubmed: 31370983
pii: S0740-5472(18)30594-4
doi: 10.1016/j.jsat.2019.05.008
pmc: PMC8215516
mid: NIHMS1714334
pii:
doi:
Substances chimiques
Delayed-Action Preparations
0
Narcotic Antagonists
0
Naltrexone
5S6W795CQM
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
34-41Subventions
Organisme : NIDA NIH HHS
ID : R01 DA029910
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW000233
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA025943
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA033679
Pays : United States
Organisme : FIC NIH HHS
ID : R25 TW009338
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA030768
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA041271
Pays : United States
Organisme : NIDA NIH HHS
ID : K24 DA017072
Pays : United States
Informations de copyright
Copyright © 2019. Published by Elsevier Inc.
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