Extended-release naltrexone and drug treatment courts: Policy and evidence for implementing an evidence-based treatment

Robertson, Allison G.; Swartz, Marvin S.

doi:10.1016/j.jsat.2017.02.016

Cited by 12 publications

(5 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years, however, there has been slow but notable increase in acceptance of all types of MOUDs in legal settings, but especially for opioid antagonists (i.e., extended release naltrexone) as these medications cannot be abused. [9][10][11] When opioid antagonist treatment is provided to individuals during or soon after release from incarceration, few remain in treatment long-term. 12,13 Understanding the impact of opioid antagonist treatment on one's quality of life may help to explain why few individuals with legal involvement remain in medication treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of Extended Release Naltrexone on Health-Related Quality of Life in Individuals with Legal Involvement and Opioid use Disorders

2021

View full text Add to dashboard Cite

Background Understanding the impact of medications for opioid use disorder on health related quality of life (QOL) may help to explain why few individuals with legal involvement remain in treatment, specifically those receiving opioid antagonists. QOL is an established predictor of treatment retention and has been shown to improve with some treatment for opioid use disorder. Yet limited research has examined QOL with opioid antagonists. We examined the impact of extended release naltrexone (XR-NTX) on QOL and retention in treatment in a randomized, multi-site trial of individuals with legal involvement. Methods The participants were 308 community-dwelling adults with current or recent legal involvement with opioid dependence at five site across United States. They were randomized to receive XR-NTX or treatment as usual for 6 months. QOL was measured every 2 weeks using Euro QOL individual items, summary index score, and health state today metric. Results No significant difference in QOL scores were observed between the two groups at the completion of active treatment or on follow up at 52 and 78 weeks. There were no time effects of treatment on scores. Contrary to expectation, baseline and average QOL did not predict retention in treatment. Conclusion In contrast to prior research, our findings did not demonstrate significant changes (improvements or decreases) in QOL associated with XR-NTX treatment. Clinicians may consider that individuals receiving XR-NTX may not experience changes in perceived well-being in response to treatment and consider discussing with patients that they may not necessarily perceive improvement in their QOL. This may help to ground patient's expectations about the effects of treatment and potentially reduce attrition from treatment with opioid antagonists.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Extended Release Naltrexone on Health-Related Quality of Life in Individuals with Legal Involvement and Opioid use Disorders

2021

View full text Add to dashboard Cite

show abstract

“…The potential reasons for sluggish naltrexone uptake has been the subject of several studies. These studies demonstrate that the reasons for the low uptake of naltrexone are varied, complex, and originate from several institutional and individual-level barriers [47][48][49][50][51]. Fundamental to the prompt adoption of any evidence-based practice are policies and procedures that promote accessibility and ease of use [52].…”

Section: Discussionmentioning

confidence: 99%

Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities

Qeadan

Mensah

et al. 2021

IJERPH

View full text Add to dashboard Cite

Background: Naltrexone, a medication for addiction treatment (MAT), is an FDA-approved medication recommended for the treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and efficacy of naltrexone, only a small percentage of individuals with AUD receive treatment. Objectives: To identify trends for the prescription of naltrexone in AUD admissions in substance use treatment centers across the U.S. Methods: Data from the 2000–2018 U.S. Treatment Episode Data Set: Admissions (TEDS-A) were used in temporal trend analysis of naltrexone prescription in admissions that only used alcohol. Data from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) were also used to characterize medication use among AUD clients across different treatment service settings. Results: Treatment of AUD with naltrexone was 0.49% in 2000 and tripled from 0.53% in 2015 to 1.64% in 2018 in AUD admissions (p < 0.0001 for the Cochran–Armitage trend test). Women, middle-aged adults, and admissions for clients living in the Northeast U.S. were more likely to be prescribed naltrexone than their respective counterparts, as were admissions with prior treatment episodes and referrals through alcohol/drug use care providers, who paid for treatment primarily through private insurance, used alcohol daily in the month prior to admission, and waited 1–7 days to enter treatment. Naltrexone was more commonly prescribed by AUD admissions compared to acamprosate and disulfiram and was more frequently prescribed in residential and outpatient services as opposed to hospital inpatient services. Conclusions: Naltrexone remains underutilized for AUD, and factors that influence prescription of medication are multifaceted. This study may contribute to the creation of effective interventions aimed at reducing naltrexone disparities for AUD.

show abstract

“…Despite efforts to engage opioid-addicted patients on parole and probation in pharmacotherapy, the criminal justice system has had a traditional preference for treatments that do not utilize medications (Bonnie, 2006; Hubbard, Collins, Rachal, & Cavanaugh, 1988). This preference appears to be slowly changing (Robertson & Swartz, 2018), although the extent of the change is presently difficult to quantify.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy for opioid addiction in community corrections

Schwartz

Mitchell

O’Grady

et al. 2018

International Review of Psychiatry

View full text Add to dashboard Cite

Pharmacotherapy for opioid addiction with methadone, buprenorphine, and naltrexone has proven efficacy in reducing illicit opioid use. These treatments are underutilized among opioid-addicted individuals on parole, probation or in drug courts. This paper examines the peer-reviewed literature on the effectiveness of pharmacotherapy for opioid addiction of adults under community-based criminal justice supervision in the US. Compared to general populations, there are relatively few papers addressing the separate impact of pharmacotherapy on individuals under community supervision. Tentative conclusions can be drawn from the extant literature. Reasonable evidence exists that illicit opioid use and self-reported criminal behavior decline after treatment entry and that these outcomes are as favorable among individuals under criminal justice supervision as the general treatment population. Surprisingly, there is no conclusive evidence regarding the extent to which pharmacotherapy impacts the likelihood of arrest and incarceration among individuals under supervision. However, given the proven efficacy of these three medications in reducing illicit opioid use and the evidence that in the general population, methadone and buprenorphine treatment are associated with reduction in overdose mortality, the use of all three pharmacotherapies among patients under criminal justice supervision should be expanded while more data are collected on their impact on arrest and incarceration.

show abstract

Extended-release naltrexone and drug treatment courts: Policy and evidence for implementing an evidence-based treatment

Cited by 12 publications

References 45 publications

Impact of Extended Release Naltrexone on Health-Related Quality of Life in Individuals with Legal Involvement and Opioid use Disorders

Impact of Extended Release Naltrexone on Health-Related Quality of Life in Individuals with Legal Involvement and Opioid use Disorders

Trends in the Use of Naltrexone for Addiction Treatment among Alcohol Use Disorder Admissions in U.S. Substance Use Treatment Facilities

Pharmacotherapy for opioid addiction in community corrections

Contact Info

Product

Resources

About