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A week-long outpatient induction onto XR-naltrexone in patients with opioid use disorder.

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Title: A week-long outpatient induction onto XR-naltrexone in patients with opioid use disorder.
Authors: Sibai, Mohammad (AUTHOR), Mishlen, Kaitlyn (AUTHOR), Nunes, Edward V. (AUTHOR), Levin, Frances R. (AUTHOR), Mariani, John J. (AUTHOR), Bisaga, Adam (AUTHOR)
Source: American Journal of Drug & Alcohol Abuse. 2020, Vol. 46 Issue 3, p289-296. 8p.
Subjects: Controlled release drugs, Naltrexone, Pilot projects, Substance abuse, Narcotic antagonists, Buprenorphine, Drug withdrawal symptoms, Intramuscular injections, Disease relapse, Controlled release preparations, Research funding
Abstract: Background: Extended-release (XR) naltrexone can prevent relapse to opioid use disorder following detoxification. However, one of the barriers to initiating XR-naltrexone is the recommendation for a 7-10-day period of abstinence from opioids prior to the first dose.Objectives: The current study evaluated the feasibility of an XR-naltrexone induction protocol that can be implemented over 1 week in the outpatient clinic.Methods: Participants (N = 44) were seen in the clinic daily. On Day 1, after abstaining from opioids for at least 12 h, they received buprenorphine 6-8 mg. Adjunctive medications (clonidine, clonazepam, zolpidem, trazodone, and prochlorperazine) were dispensed on Days 2-5, while ascending oral doses of naltrexone were given on Days 3-5 starting with 1 mg dose. An injection of XR-naltrexone was given on Day 5, 1 h after receiving and tolerating naltrexone 24 mg.Results: Of the 44 participants (38 males), 35 (80%) were heroin users and 9 (20%) used prescription opioids. A total of 26 participants (59%) completed the induction and received their first injection of XR-naltrexone. XR-naltrexone was initiated in 54% (19/35) of heroin users and 78% (7/9) of prescription opioid users.Conclusion: The results support the feasibility of a week-long outpatient induction onto XR-naltrexone with ascending doses of naltrexone and standing doses of adjunctive medications. By circumventing the need for a protracted period of abstinence and mitigating the severity of withdrawal symptoms experienced during naltrexone titration, this strategy has the potential to increase patient acceptability and access to relapse prevention treatment with XR-naltrexone. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd 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: A week-long outpatient induction onto XR-naltrexone in patients with opioid use disorder.
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  Data: <searchLink fieldCode="AR" term="%22Sibai%2C+Mohammad%22">Sibai, Mohammad</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mishlen%2C+Kaitlyn%22">Mishlen, Kaitlyn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nunes%2C+Edward+V%2E%22">Nunes, Edward V.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Levin%2C+Frances+R%2E%22">Levin, Frances R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mariani%2C+John+J%2E%22">Mariani, John J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bisaga%2C+Adam%22">Bisaga, Adam</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Drug+%26+Alcohol+Abuse%22">American Journal of Drug & Alcohol Abuse</searchLink>. 2020, Vol. 46 Issue 3, p289-296. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Controlled+release+drugs%22">Controlled release drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Naltrexone%22">Naltrexone</searchLink><br /><searchLink fieldCode="DE" term="%22Pilot+projects%22">Pilot projects</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotic+antagonists%22">Narcotic antagonists</searchLink><br /><searchLink fieldCode="DE" term="%22Buprenorphine%22">Buprenorphine</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+withdrawal+symptoms%22">Drug withdrawal symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Intramuscular+injections%22">Intramuscular injections</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Controlled+release+preparations%22">Controlled release preparations</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Extended-release (XR) naltrexone can prevent relapse to opioid use disorder following detoxification. However, one of the barriers to initiating XR-naltrexone is the recommendation for a 7-10-day period of abstinence from opioids prior to the first dose.<bold>Objectives: </bold>The current study evaluated the feasibility of an XR-naltrexone induction protocol that can be implemented over 1 week in the outpatient clinic.<bold>Methods: </bold>Participants (N = 44) were seen in the clinic daily. On Day 1, after abstaining from opioids for at least 12 h, they received buprenorphine 6-8 mg. Adjunctive medications (clonidine, clonazepam, zolpidem, trazodone, and prochlorperazine) were dispensed on Days 2-5, while ascending oral doses of naltrexone were given on Days 3-5 starting with 1 mg dose. An injection of XR-naltrexone was given on Day 5, 1 h after receiving and tolerating naltrexone 24 mg.<bold>Results: </bold>Of the 44 participants (38 males), 35 (80%) were heroin users and 9 (20%) used prescription opioids. A total of 26 participants (59%) completed the induction and received their first injection of XR-naltrexone. XR-naltrexone was initiated in 54% (19/35) of heroin users and 78% (7/9) of prescription opioid users.<bold>Conclusion: </bold>The results support the feasibility of a week-long outpatient induction onto XR-naltrexone with ascending doses of naltrexone and standing doses of adjunctive medications. By circumventing the need for a protracted period of abstinence and mitigating the severity of withdrawal symptoms experienced during naltrexone titration, this strategy has the potential to increase patient acceptability and access to relapse prevention treatment with XR-naltrexone. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of American Journal of Drug & Alcohol Abuse is the property of Taylor & Francis Ltd 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: 10.1080/00952990.2019.1700265
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        Text: English
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    Subjects:
      – SubjectFull: Controlled release drugs
        Type: general
      – SubjectFull: Naltrexone
        Type: general
      – SubjectFull: Pilot projects
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      – SubjectFull: Disease relapse
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      – SubjectFull: Research funding
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      – TitleFull: A week-long outpatient induction onto XR-naltrexone in patients with opioid use disorder.
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              Text: 2020
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