Opioid Use Reduced by Extended-Release Naltrexone Injections

different types of pills scattered
different types of pills scattered
Extended-release naltrexone maintained abstinence from heroin and other illicit substances.

Compared with buprenorphine-naloxone, use of extended-release naltrexone maintained abstinence from heroin and other illicit substances at a similar rate, according to the results of research published in JAMA Psychiatry.

In this open-label 12-week trial, researchers randomly assigned outpatients from addiction clinics to receive intramuscular extended-release naltrexone, 380 mg every 4 weeks (n=80) or buprenorphine-naloxone, 4 to 24 mg/d n=79). Researchers evaluated the completion rates, the proportion of opioid-negative drug test results, and the number of days participants used heroin or other illicit opioids.

A total of 66% of patients completed the trial, with a noninferior rate of completion in the extended-release naltrexone group compared with the buprenorphine-naloxone group (P =.04). The mean (SD) length of trial participation was 69.3 (25.9) days for extended-release naltrexone and 63.7 (29.9) days for buprenorphine-naloxone.

Extended-release naltrexone use resulted in a noninferior proportion of total number of opioid-negative drug test results (mean [SD] 0.9 [0.3]) compared with buprenorphine-naloxone (0.8 [0.4]; P <.001). Similarly, use of heroin and other illicit opioids was noninferior in the extended-release naltrexone group (P <.001 for both).

In a superiority analysis, use of extended-release naltrexone was associated with significantly lower rates of heroin and other illicit opioid use. Most other illicit substances used were not significantly different between the two groups.

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The study authors concluded that “maintaining short-term abstinence from illicit opioids and other substances with extended-release naltrexone was as effective and safe as [with] buprenorphine-naloxone. Extended-release naltrexone should be an available treatment option for opioid-dependent individuals.”


Tanum L, Solli KK, Latif ZE, et al. The effectiveness of injectable extended-release naltrexone vs daily buprenorphine-naloxone for opioid dependence: a randomized clinical noninferiority trial [published online October 18, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3206