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Baseline characteristics of patients predicting suitability for rapid naltrexone induction.

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Title: Baseline characteristics of patients predicting suitability for rapid naltrexone induction.
Authors: Mogali, Shanthi, Khan, Nabil A., Drill, Esther S., Pavlicova, Martina, Sullivan, Maria A., Nunes, Edward, Bisaga, Adam
Source: American Journal on Addictions. Apr2015, Vol. 24 Issue 3, p258-264. 7p. 3 Charts, 1 Graph.
Subjects: Opioid abuse, Drug abuse treatment, Naltrexone, Clonidine, Logistic regression analysis, Psychosocial factors, Heroin
Abstract: Background and Objectives Extended-release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre-treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment. Methods A chart review of 150 consecutive research participants ( N = 84 completers and N = 66 non-completers) undergoing a rapid naltrexone induction with the buprenorphone-clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction-detoxification. Results Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level. Conclusions Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone. Scientific Significance Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction. (Am J Addict 2015;24:258-264) [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Baseline characteristics of patients predicting suitability for rapid naltrexone induction.
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  Data: <searchLink fieldCode="AR" term="%22Mogali%2C+Shanthi%22">Mogali, Shanthi</searchLink><br /><searchLink fieldCode="AR" term="%22Khan%2C+Nabil+A%2E%22">Khan, Nabil A.</searchLink><br /><searchLink fieldCode="AR" term="%22Drill%2C+Esther+S%2E%22">Drill, Esther S.</searchLink><br /><searchLink fieldCode="AR" term="%22Pavlicova%2C+Martina%22">Pavlicova, Martina</searchLink><br /><searchLink fieldCode="AR" term="%22Sullivan%2C+Maria+A%2E%22">Sullivan, Maria A.</searchLink><br /><searchLink fieldCode="AR" term="%22Nunes%2C+Edward%22">Nunes, Edward</searchLink><br /><searchLink fieldCode="AR" term="%22Bisaga%2C+Adam%22">Bisaga, Adam</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+on+Addictions%22">American Journal on Addictions</searchLink>. Apr2015, Vol. 24 Issue 3, p258-264. 7p. 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Opioid+abuse%22">Opioid abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+abuse+treatment%22">Drug abuse treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Naltrexone%22">Naltrexone</searchLink><br /><searchLink fieldCode="DE" term="%22Clonidine%22">Clonidine</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Psychosocial+factors%22">Psychosocial factors</searchLink><br /><searchLink fieldCode="DE" term="%22Heroin%22">Heroin</searchLink>
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  Data: Background and Objectives Extended-release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre-treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment. Methods A chart review of 150 consecutive research participants ( N = 84 completers and N = 66 non-completers) undergoing a rapid naltrexone induction with the buprenorphone-clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction-detoxification. Results Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level. Conclusions Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone. Scientific Significance Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction. (Am J Addict 2015;24:258-264) [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ajad.12180
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      – SubjectFull: Naltrexone
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      – TitleFull: Baseline characteristics of patients predicting suitability for rapid naltrexone induction.
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              Text: Apr2015
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