Adherence to extended release naltrexone: Patient and treatment characteristics

Chang, Grace; Crawford, Mitchell B.; Pitts, Michelle; Schein, Abigail Z.; Goodwin, Katherine; Enggasser, Justin L.

doi:10.1111/ajad.12786

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…93,94 Fiveyear outcome data for naltrexone are not available, with most studies focused on data over a 6-month period 57,94,109 with a few studies looking up to a year showing some positive retention in the right populations with the right support. 110,111 Research demonstrated an association of naltrexone injections with long-term recovery among nurses (2 years), but, again, this group was highly motivated, a generally higher socioeconomic status cohort, and heavily involved in a structured professional monitoring program. 112 Given such robust response rates by this nursing cohort, it raises the question why this level of oversight and support is not more broadly used in the treatment community.…”

Section: Preparation/administrationmentioning

confidence: 99%

Medication-Assisted Treatment for Opioid-Use Disorder

Oesterle

Thusius

Rummans

et al. 2019

Mayo Clinic Proceedings

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The United States is in the midst of a national opioid epidemic. Physicians are encouraged both to prevent and treat opioid-use disorders (OUDs). Although there are 3 Food and Drug Administration-approved medications to treat OUD (methadone, buprenorphine, and naltrexone) and there is ample evidence of their efficacy, they are not used as often as they should. We provide a brief review of the 3 primary medications used in the treatment of OUD. Using data from available medical literature, we synthesize existing knowledge and provide a framework for how to determine the optimal approach for outpatient management of OUD with medication-assisted treatments.

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Section: Preparation/administrationmentioning

confidence: 99%

Medication-Assisted Treatment for Opioid-Use Disorder

Oesterle

Thusius

Rummans

et al. 2019

Mayo Clinic Proceedings

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“…The extended‐release form of NTX known as Vivitrol, approved by the FDA in 2010, yields plasma levels of NTX that are sufficient to bind to the mu‐opioid receptors for up to 28 days and can be administered in outpatient clinics. However, a pilot study conducted with Vivitrol showed that 32% of the active study group failed to complete the four monthly injections, highlighting the current problem of patient adherence with monthly injections 7,8 …”

Section: Introductionmentioning

confidence: 99%

“…However, a pilot study conducted with Vivitrol showed that 32% of the active study group failed to complete the four monthly injections, highlighting the current problem of patient adherence with monthly injections. 7,8 Another potential solution to the poor adherence with NTX is an extended-release subcutaneous NTX implant. These implants, if successful, would substantially reduce the patient adherence barrier through longer durations of active medication delivery.…”

mentioning

confidence: 99%

Fentanyl‐induced respiratory depression in rodents is inhibited by bioabsorbable, subcutaneous naltrexone implants at 3.5 months

Benner,

Cohen,

Hollenbaugh

et al. 2023

Addiction Biology

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The aim of this study is to determine if extended‐release, bioabsorbable, subcutaneous naltrexone (NTX) implants inhibit respiratory depression after an IV injection of fentanyl. Bioabsorbable implants fabricated from two different release‐controlling polymers, poly‐D‐L‐lactide (PDLLA) and polycaprolactone (PCL), alone (placebo) or containing NTX, were subcutaneously implanted in Sprague Dawley rats. After 3.5 months of implantation, the rodents were administered an IV bolus of fentanyl through the tail vein. The placebo implant rats received a dose of 4 micrograms (mcg) ‐ (10 mcg/kg/dose), while the NTX implanted animals received a dose of 8 mcg (20 mcg/kg/dose). The minimum active dose of fentanyl that caused a > 50 ± 2% depression in the respiration rate in the placebo implanted rodents was 4 mcg. The respiration rate of the placebo implanted rats dropped from 208 ± 14 breaths/minute at predose, to 84 ± 12 breaths/minute (p = 0.0003) at 2 min. In contrast, all NTX implanted animals easily tolerated twice the dose of 8 mcg of fentanyl without any significant reduction in respiration rate. The mean respiration rate = increased from 164 ± 22 breaths/minute at predose to 178 ± 17 breaths/minute (p = 0.24) at 2 min. The mean plasma concentrations of NTX, 3.5 months after implantation, ranged from 7.4 (±1.1) ng/mL to 80.3 (±37.5) ng/mL. Bioabsorbable implants containing NTX effectively blocked fentanyl‐induced respiratory depression in rodents as compared with placebo implants, 3.5 months after implantation.

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