TY - JOUR
KW - Adult
KW - Alcoholism/drug therapy/psychology
KW - Delayed-Action Preparations/therapeutic use
KW - Female
KW - Humans
KW - Male
KW - Medication Adherence/psychology
KW - Middle Aged
KW - Naltrexone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Opioid-Related Disorders/drug therapy/psychology
KW - Outcome Assessment (Health Care)
KW - Psychotherapy
KW - Retrospective Studies
KW - United States
KW - Veterans Health/statistics & numerical data
KW - Veterans/psychology
AU - G. Chang
AU - M. Crawford
AU - M. Pitts
AU - A. Z. Schein
AU - K. Goodwin
AU - J. L. Enggasser
A1 - 
AB - BACKGROUND AND OBJECTIVES: Despite the promise of extended release naltrexone in the treatment of the opioid and alcohol use disorders, challenges with initiation and subsequent adherence have limited its potential. The purpose of this study is to identify the patient and treatment characteristics associated with adherence to extended release naltrexone. METHODS: Retrospective cohort study of 155 veterans who initiated the medication in FY 2014 and FY2015. Medical records were abstracted for patient and treatment data including preferred drug and utilization of substance use treatment in the year before and after medication initiation. RESULTS: Sample characteristics include 94% male, 70% domiciled, 60% without current legal problems, 30% employed, and preferred drug being opioids for 55% and alcohol for 45%. The mean of five extended release naltrexone injections did not differ by preferred drug. Treatment variables associated with medication adherence included concurrent substance use residential, individual, group, and psychiatric therapies (all p < .05) with inpatient detoxification admissions halved afterward (p < .0001) . DISCUSSION AND CONCLUSIONS: Whereas most studies of extended release naltrexone have focused on patients with either alcohol or opioid use disorders for 6 months, this study allowed for a direct comparison of adherence in both groups over a year. The average treatment persistence in this veteran sample is greater than described in other public sector studies and may illustrate the importance of concurrent psychosocial therapies. SCIENTIFIC SIGNIFICANCE: Results extend the findings of other studies and add to an emerging appreciation of the factors associated with treatment retention for extended release naltrexone. (Am J Addict 2018;27:524-530).
BT - The American journal on addictions
C5 - Opioids & Substance Use
CP - 6
CY - England
DO - 10.1111/ajad.12786
IS - 6
JF - The American journal on addictions
N2 - BACKGROUND AND OBJECTIVES: Despite the promise of extended release naltrexone in the treatment of the opioid and alcohol use disorders, challenges with initiation and subsequent adherence have limited its potential. The purpose of this study is to identify the patient and treatment characteristics associated with adherence to extended release naltrexone. METHODS: Retrospective cohort study of 155 veterans who initiated the medication in FY 2014 and FY2015. Medical records were abstracted for patient and treatment data including preferred drug and utilization of substance use treatment in the year before and after medication initiation. RESULTS: Sample characteristics include 94% male, 70% domiciled, 60% without current legal problems, 30% employed, and preferred drug being opioids for 55% and alcohol for 45%. The mean of five extended release naltrexone injections did not differ by preferred drug. Treatment variables associated with medication adherence included concurrent substance use residential, individual, group, and psychiatric therapies (all p < .05) with inpatient detoxification admissions halved afterward (p < .0001) . DISCUSSION AND CONCLUSIONS: Whereas most studies of extended release naltrexone have focused on patients with either alcohol or opioid use disorders for 6 months, this study allowed for a direct comparison of adherence in both groups over a year. The average treatment persistence in this veteran sample is greater than described in other public sector studies and may illustrate the importance of concurrent psychosocial therapies. SCIENTIFIC SIGNIFICANCE: Results extend the findings of other studies and add to an emerging appreciation of the factors associated with treatment retention for extended release naltrexone. (Am J Addict 2018;27:524-530).
PB - . This article is a U.S. Government work and is in the public domain in the USA
PP - England
PY - 2018
SN - 1521-0391; 1055-0496
SP - 524
EP - 530
EP - 
T1 - Adherence to extended release naltrexone: Patient and treatment characteristics
T2 - The American journal on addictions
TI - Adherence to extended release naltrexone: Patient and treatment characteristics
U1 - Opioids & Substance Use
U2 - 30106489
U3 - 10.1111/ajad.12786
VL - 27
VO - 1521-0391; 1055-0496
Y1 - 2018
ER -