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 2011–2015, during which participants were offered 3 monthly injections of XR-NTX at no cost. The survey consisted of 35 questions covering a total of 4 domains: (1) Substance use; (2) Treatment continuation; (3) Barriers; and (4) Attitudes. Results 57 respondents were successfully surveyed, including 50% of those initially receiving all 3 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.”

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Terror Management Theory (TMT) states that the awareness of one’s own death causes humans to experience intense anxiety, which must be continuously managed. Much of the research on TMT has focused on negative outcomes, rather than prosocial behavior, begging the question: “Can priming individuals with the thought of their own death trigger them to behave in ways that benefit others?”. Jonas et al. (2002), found that when mortality salience was primed prosocial behavior increased. In line with TMT, they hypothesized that people may behave in a more prosocial manner as it fits in with their personal values. The present study recruited 108 students who were randomly assigned to a mortality salience (MS) or control condition. Participants also completed baseline self-reports, which included measures of ageism, social desirability, personality, and empathy. After the study seemed to end, participants were given a disguised measure of helping behavior, which they believed to be an interest survey for a student volunteer group. Preliminary analyses indicate that those in the MS condition were more willing to be contacted to volunteer with kids than being contacted to volunteer with older adults. We also found that those in the MS condition were more likely to be contacted to volunteer with kids than those in the control condition. Our findings are consistent with previous work showing that individuals favor their ingroup when primed with their death. This reflects the importance of focused efforts on encouraging young people to identify with older adults and on promoting prosocial behavior.

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