Use of Naltrexone to Treat Opioid Addiction in a Country in Which Methadone and Buprenorphine Are Not Available

Krupitsky, Evgeny; Zvartau, Edwin; Woody, George

doi:10.1007/s11920-010-0135-5

Cited by 90 publications

(70 citation statements)

References 21 publications

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“…Combining XR‐NTX with employment‐based reinforcement has also been shown to be effective in unemployed adults 114. Others who may benefit include incarcerated persons and those without access to opioid agonist treatment 60, 71, 115. Criminal justice offenders treated with XR‐NTX had double the median length of opioid‐free time compared with those who received brief counseling and a referral to community treatment 71.…”

Section: Current Approach To Treatment Of Opioid Use Disorder: Choosimentioning

confidence: 99%

Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies

et al. 2018

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Background and ObjectivesOpioid use disorder (OUD) is a chronic condition with potentially severe health and social consequences. Many who develop moderate to severe OUD will repeatedly seek treatment or interact with medical care via emergency department visits or hospitalizations. Thus, there is an urgent need to develop feasible and effective approaches to help persons with OUD achieve and maintain abstinence from opioids. Treatment that includes one of the three FDA‐approved medications is an evidence‐based strategy to manage OUD. The purpose of this review is to address practices for managing persons with moderate to severe OUD with a focus on opioid withdrawal and naltrexone‐based relapse‐prevention treatment.MethodsLiterature available on PubMed was used to review the evolution of treatment strategies from the 1960s onward to manage opioid withdrawal and initiate treatment with naltrexone.ResultsEmerging practices for extended‐release naltrexone induction include the use of agonist tapers and adjuvant medications. Clinical challenges frequently encountered when initiating this therapy include managing withdrawal and ongoing opioid use during treatment. Clinical factors may inform decisions regarding patient selection and length of naltrexone treatment, such as recent opioid use and patient preferences.Conclusions and Scientific SignificanceTreatment strategies to manage opioid withdrawal have evolved, but many patients with OUD do not receive medication for the prevention of relapse. Clinical strategies for induction onto extended‐release naltrexone are now available and can be safely and effectively implemented in specialty and select primary care settings. (© 2018 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP);27:177–187)

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Section: Current Approach To Treatment Of Opioid Use Disorder: Choosimentioning

confidence: 99%

Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies

et al. 2018

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“…In the past decade, research and commercial investments in medication development have yielded new, effective, and safe pharmacotherapies to treat OUDs and AUDs, including buprenorphine, acamprosate, and extended-release injectable naltrexone (Krupitsky et al, 2010;Ling et al, 2005;O'Malley et al, 2007;Rösner et al, 2010Rösner et al, , 2011 Despite the priority placed on adoption of SUD medications, data have repeatedly demonstrated a signifi cant "research-to-practice" gap, with notably limited pharmacotherapy adoption in publicly funded SUD treatment programs Garner, 2009;Knudsen et al, 2010;Lamb et al, 1998). Data from the early 2000s reveal that publicly funded treatment programs were less likely than privately funded programs to prescribe disulfi ram, buprenorphine, tablet naltrexone, acamprosate, and injectable naltrexone Knudsen et al, 2006Knudsen et al, , 2007aRoman et al, 2011).…”

mentioning

confidence: 99%

Disparities in Access to Physicians and Medications for the Treatment of Substance Use Disorders Between Publicly and Privately Funded Treatment Programs in the United States

Abraham

Knudsen

Rieckmann

et al. 2013

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Prior research suggests that publicly funded substance use disorder (SUD) treatment programs lag behind privately funded programs in adoption of evidence-based practices, resulting in disparities in access to high-quality SUD treatment. These disparities highlight a critical public health concern because the majority of SUD patients in the United States are treated in the publicly funded treatment sector. This study uses recent data to examine disparities in access to physicians and availability of medications for the treatment of SUDs between publicly and privately funded SUD treatment programs. Method: Data were collected from 595 specialty SUD treatment programs from 2007 to 2010 via face-to-face interviews, mailed surveys, and telephone interviews with treatment program administrators. Results: Publicly funded programs were less likely than privately funded programs to have a physician on staff, even after controlling for several organizational characteristics that were associated with access to physicians. The results of negative binomial regression indicated that, even after taking into account physician access and other organizational variables, publicly funded programs prescribed fewer SUD medications than privately funded SUD treatment programs. Conclusions: Patients seeking treatment in publicly funded treatment programs continue to face disparities in access to high-quality SUD treatment that supports patients' choices among a range of medication options. However, implementation of the Affordable Care Act may facilitate greater access to physicians and use of medications in publicly funded SUD treatment programs. (J. Stud. Alcohol Drugs, 74, 258-265, 2013)

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“…A lack of treatment methods may also affect the number of drug users that register. Methadone and buprenorphine maintenance programmes are illegal [7,17], and needle exchange programmes are limited [7], as well as effective social support programmes. However, there is some treatment offered if paid for by the patient.…”

Section: Discussionmentioning

confidence: 99%

Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study

Dahl

Rezvyy

Bogdanov³

et al. 2017

International Journal of Circumpolar Health

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Both in Norway and Russia a considerable portion of the population have substance use disorders. However, the knowledge about outpatient services treating substance use disorders in Norway and Russia is limited. This study will describe and compare outpatient clinics treating substance use disorders in Arkhangelsk in Northwest Russia and in Bodø and Tromsø in Northern Norway on availability, accessibility and treated prevalence (patients treated in one year). The managers (N=3) of the outpatient clinics (N=3) were interviewed with the European Service Mapping Schedule (ESMS) and the International Classification of Mental Health Care (ICMHC). The interviews were supplemented by e-mail and phone calls. The treatment in Arkhangelsk was mainly biologically oriented (medical), while a greater variety of methods was available in Bodø and Tromsø. The clinic in Russia was a drop-in clinic, while in Norway patients needed a referral to get an appointment in the clinic. Patients treated in Arkhangelsk (treated prevalence) was 1662, while in Bodø it was 233 and in Tromsø 220. The present study revealed great differences between the clinics involved in accessibility, availability and treated prevalence. Cultural traditions and budgeting of the mental health care system could explain some of the findings.

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Use of Naltrexone to Treat Opioid Addiction in a Country in Which Methadone and Buprenorphine Are Not Available

Cited by 90 publications

References 21 publications

Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies

Antagonists in the medical management of opioid use disorders: Historical and existing treatment strategies

Disparities in Access to Physicians and Medications for the Treatment of Substance Use Disorders Between Publicly and Privately Funded Treatment Programs in the United States

Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study

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