TY - JOUR
KW - opioid use disorder
KW - Criminal justice
KW - Extended release naltrexone
KW - medication assisted treatment
KW - Medication for opioid use disorder
KW - Quality of Life
AU - E. Pivovarova
AU - H. S. Min
AU - P. D. Friedmann
A1 - 
AB - Understanding the impact of medications for opioid use disorder on health related quality of life (QOL) may help to explain why few individuals with legal involvement remain in treatment, specifically those receiving opioid antagonists. QOL is an established predictor of treatment retention and has been shown to improve with some treatment for opioid use disorder. Yet limited research has examined QOL with opioid antagonists. We examined the impact of extended release naltrexone (XR-NTX) on QOL and retention in treatment in a randomized, multi-site trial of individuals with legal involvement. Methods: The participants were 308 community-dwelling adults with current or recent legal involvement with opioid dependence at five site across United States. They were randomized to receive XR-NTX or treatment as usual for 6 months. QOL was measured every 2 weeks using Euro QOL individual items, summary index score, and health state today metric. Results: No significant difference in QOL scores were observed between the two groups at the completion of active treatment or on follow up at 52 and 78 weeks. There were no time effects of treatment on scores. Contrary to expectation, baseline and average QOL did not predict retention in treatment. Conclusion: In contrast to prior research, our findings did not demonstrate significant changes (improvements or decreases) in QOL associated with XR-NTX treatment. Clinicians may consider that individuals receiving XR-NTX may not experience changes in perceived well-being in response to treatment and consider discussing with patients that they may not necessarily perceive improvement in their QOL. This may help to ground patient's expectations about the effects of treatment and potentially reduce attrition from treatment with opioid antagonists.
AD - Department of Family Medicine & Community Health and Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA.; Massachusetts Center of Excellence for Specialty Courts, Shrewsbury, Massachusetts, USA.; Department of Population Health and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.; Department of Population Health and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.; Department of Medicine, University of Massachusetts Medical School - Baystate, Springfield, Massachusetts, USA.; Baystate Health, Springfield, Massachusetts, USA.
BT - Substance abuse
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CY - United States
DO - 10.1080/08897077.2020.1809603
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Understanding the impact of medications for opioid use disorder on health related quality of life (QOL) may help to explain why few individuals with legal involvement remain in treatment, specifically those receiving opioid antagonists. QOL is an established predictor of treatment retention and has been shown to improve with some treatment for opioid use disorder. Yet limited research has examined QOL with opioid antagonists. We examined the impact of extended release naltrexone (XR-NTX) on QOL and retention in treatment in a randomized, multi-site trial of individuals with legal involvement. Methods: The participants were 308 community-dwelling adults with current or recent legal involvement with opioid dependence at five site across United States. They were randomized to receive XR-NTX or treatment as usual for 6 months. QOL was measured every 2 weeks using Euro QOL individual items, summary index score, and health state today metric. Results: No significant difference in QOL scores were observed between the two groups at the completion of active treatment or on follow up at 52 and 78 weeks. There were no time effects of treatment on scores. Contrary to expectation, baseline and average QOL did not predict retention in treatment. Conclusion: In contrast to prior research, our findings did not demonstrate significant changes (improvements or decreases) in QOL associated with XR-NTX treatment. Clinicians may consider that individuals receiving XR-NTX may not experience changes in perceived well-being in response to treatment and consider discussing with patients that they may not necessarily perceive improvement in their QOL. This may help to ground patient's expectations about the effects of treatment and potentially reduce attrition from treatment with opioid antagonists.
PP - United States
PY - 2020
SN - 1547-0164; 0889-7077
SP - 1
EP - 7
EP - 
T1 - Impact of extended release naltrexone on health-related quality of life in individuals with legal involvement and opioid use disorders
T2 - Substance abuse
TI - Impact of extended release naltrexone on health-related quality of life in individuals with legal involvement and opioid use disorders
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 32870122
U3 - 10.1080/08897077.2020.1809603
VO - 1547-0164; 0889-7077
Y1 - 2020
Y2 - Sep 1
ER -