Interest in Extended Release Naltrexone among Opioid Users

Abstract

Background/Aims: Treatment for addiction to illicit opioids has, thus far, been limited to 2 main approaches: maintaining physical dependence by administering opioids medically and medication-free abstinence with psychosocial support. Assisted abstinence by taking daily tablets with the opioid antagonist naltrexone is rarely practiced, but it is unclear whether this is due to the limited efficacy of this method or because of user opposition to antagonist medication. Therefore, we wanted to investigate opioid users' interest in antagonist treatment with naltrexone, administered as extended release injection, which supports abstinence by blocking illicit opioids for 4-5 weeks per administration. Method: A one-page questionnaire was distributed among opiate users at a broad range of outreach facilities and a total of 731 answered surveys were analysed. Results: More than half of the opioid users in our study were ‘very' or ‘quite' interested in receiving a 4-weekly opioid-blocking medication for a year (n = 421), while less than a quarter (n = 164) were ‘not interested' at all. Conclusion: We discovered a high user interest for naltrexone treatment, suggesting that the interest for such treatment was not a barrier to the implementation of extended release naltrexone treatment.

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

“…Previous studies have reported that many patients in OMT express a main goal of opioid abstinence (33,44,45). The before mentioned survey conducted by our research team, also discovered a high interest in XR-NTX treatment among OMT-patients (32). Since discontinuing substitution medication is risky even when patients are highly motivated, rather few succeed in detoxification from OMT and many relapse to opioid use (46).…”

“…These participants (40.2%) reported more severe ongoing addiction-related problems compared to the participants recruited from the OMT-population, and were at higher risk of overdose due to their pattern of uncontrolled use of illicit substances (35). In a previous survey performed by our research group, opioid-dependent individuals not currently in OMT reported a higher interest in XR-NTX treatment than those enrolled in OMT (32). Thus, a number of opioid-dependent individuals whom for different reasons have chosen not to be enrolled in an available OMT treatment, have shown, both in attitude and in behaviour, attraction to XR-NTX treatment.…”

“…Two European user surveys have suggested that opioid-dependent individuals would welcome abstinence support with XR-NTX as a treatment option (32,33), but such surveys are methodological limited to measuring attitudes rather than behaviour. Until recently, it has not been known how XR-NTX will be utilized in a clinical setting where OMT is easily available at no cost for the individual.…”

The Predictive Value of Degree of Preference for Extended-Release Naltrexone for Treatment Adherence, Opioid Use, and Relapse

“…The statements were scored using a 0-4 Likert scale from not interested (0) to very interested (4). For more information see Sharma Haase et al [28].…”

“…However, there is no standardized or validated instrument for preference within SUD treatment [11]. The questions were designed to reflect the degree of commitment level to abstinence with naltrexone [28]. We assessed internal consistency for the 5 variables in terms of item-total correlations and Cronbach's alpha.…”