HealthDay News — Extended-release naltrexone is associated with a lower rate of opioid relapse than usual treatment among criminal justice offenders, according to a study published in the March 31 issue of the New England Journal of Medicine.
Joshua D. Lee, MD, from the New York State Psychiatric Institute in New York City, and colleagues conducted an open-label trial to compare a 24-week course of extended-release naltrexone with usual treatment for the prevention of opioid relapse among adult criminal justice offenders with a history of opioid dependence. Participants (153 assigned to extended-release naltrexone and 155 to usual treatment) were followed for the primary outcome of time to an opioid-relapse event.
The researchers found that, compared with participants assigned to usual treatment, participants assigned to extended-release naltrexone had a longer median time to relapse (10.5 versus 5.0 weeks; P < 0.001; hazard ratio, 0.49), a lower rate of relapse (43% vs 64% of participants; P < 0.001; odds ratio, 0.43), and a higher rate of opioid-negative urine samples (74% vs 56%; P < 0.001; odds ratio, 2.30) during the 24-week treatment phase. The rates of opioid-negative urine samples were equivalent at week 78 (approximately 1 year after the end of the treatment phase; 46% in each group; P = 0.91).
“In this trial involving criminal justice offenders, extended-release naltrexone was associated with a rate of opioid relapse that was lower than that with usual treatment,” the authors wrote.
Several authors disclosed financial ties to pharmaceutical companies, including Alkermes, which provided trial medication.
Lee JD, Friedmann PD, Kinlock TW, et al. Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders. NEJM. 2016; doi:10.1056/NEJMoa1505409.