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Heroin Addiction and Related Clinical Problems: 2023, 25, N4 (pages: 5 - 14)

Characteristics of opioid-dependent patients choosing antagonist treatment with extended-release naltrexone compared with patients in opioid maintenance treatment in Norway

Weimand B., Karlsson A.T., Solli K.K., Vederhus J.-K., Mordal J., Wergeland Digranes L., and Tanum L.

Summary: Background: Opioid dependency is a risk factor for several negative life events and conditions. The opioid receptor inhibitor extended-release naltrexone (XR-NTX) is safe and effective in reducing illicit substance use. Here, we report results of a naturalistic, multicenter, open-label trial of XR-NTX for 24 weeks, with an optional 28-week treatment extension (NaltRec study). Aims: The study aims were to compare sociodemographic and clinical variables between patients choosing XR-NTX (n=162) and those in opioid agonist treatment (OAT) (n= 155), and to compare these variables in the XR-NTX group between patients who were (n= 103) and were not (n= 59) in OAT before study inclusion. Methods: To measure objective-related factors, we used a structured interview at inclusion. Results: The XR-NTX group had fewer women, was younger and reported poorer living and social conditions than the OAT group. Both groups had serious health conditions. Across groups, 40% percent reported lifetime suicide attempts, and 60% reported abusive experiences, with 47% women and 17% men reporting sexual abuse. Age at onset of polydrug use was 20 years. Patients preferring XR-NTX to OAT reported poorer social conditions compared with those choosing OAT. Conclusions: Women and patients who are not stabilized before enrollment need specific attention to tailored supportive measures during treatment with extended-release naltrexone.