TY - JOUR
KW - Adult
KW - Delayed-Action Preparations
KW - Drug Administration Schedule
KW - Female
KW - Follow-Up Studies
KW - Health Personnel
KW - Humans
KW - Injections, Intramuscular
KW - Male
KW - Middle Aged
KW - Naltrexone/administration & dosage/therapeutic use
KW - Narcotic Antagonists/administration & dosage/therapeutic use
KW - Occupational Diseases/drug therapy
KW - Opioid-Related Disorders/drug therapy
KW - Prospective Studies
KW - Treatment Outcome
AU - Paul H. Earley
AU - Jacqueline Zummo
AU - Asli Memisoglu
AU - Bernard L. Silverman
AU - David R. Gastfriend
A1 - 
AB - OBJECTIVES: Healthcare professionals (HCPs) with opioid dependence are at risk for relapse and death, particularly in the first year of recovery; however, maintenance treatment with opioid agonists is controversial in this safety-sensitive group. We evaluated long-term safety, tolerability, and treatment outcomes of injectable, intramuscular, extended-release naltrexone (XR-NTX) in opioid-dependent HCPs. METHODS: This single-arm, multisite, open-label study was conducted in opioid-dependent HCPs who had been detoxified from opioids for at least 2 weeks. Subjects received monthly XR-NTX injections for up to 24 months, combined with counseling via intensive outpatient substance abuse treatment programs. Assessments included monthly urine opioid drug tests and routine safety assessments, along with a trimonthly short form (36) Health Survey, opioid craving questionnaire, and Treatment Satisfaction Questionnaire for Medication. RESULTS: Of 49 opioid-dependent HCPs screened, 38 enrolled and received at least 1 XR-NTX injection. Most were female (n = 31) and nurses or nursing assistants (n = 30). More than half (n = 21; 55.3%) received at least 12 injections. Seven discontinued due to adverse events (3 anxiety, 2 headache, 1 injection-site mass, 1 derealization). None experienced relapses to opioid dependence necessitating detoxification, overdose, or death during treatment. At 24 months, mean opioid craving fell by 45.2%, and short form (36) mental component scores improved by 31.1% from baseline and approached normal levels. Of 22 unemployed subjects at baseline, 45.5% improved employment status at 24 months. CONCLUSIONS: Long-term (2 years) XR-NTX was associated with no new safety concerns, and, compared with shorter-term studies in the general population, similar or better rates of retention, opioid-negative urines, opioid craving reduction, mental health functional quality of life improvement, and re-employment.
AD - Earley Consultancy, LLC, Atlanta, GA (PHE); Alkermes, Inc, Waltham, MA (JZ, AM, BLS); Treatment Research Institute, Philadelphia, PA (DRG).
BT - Journal of addiction medicine
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CP - 3
CY - United States
DO - 10.1097/ADM.0000000000000302
IS - 3
JF - Journal of addiction medicine
LA - eng
M1 - Journal Article
N2 - OBJECTIVES: Healthcare professionals (HCPs) with opioid dependence are at risk for relapse and death, particularly in the first year of recovery; however, maintenance treatment with opioid agonists is controversial in this safety-sensitive group. We evaluated long-term safety, tolerability, and treatment outcomes of injectable, intramuscular, extended-release naltrexone (XR-NTX) in opioid-dependent HCPs. METHODS: This single-arm, multisite, open-label study was conducted in opioid-dependent HCPs who had been detoxified from opioids for at least 2 weeks. Subjects received monthly XR-NTX injections for up to 24 months, combined with counseling via intensive outpatient substance abuse treatment programs. Assessments included monthly urine opioid drug tests and routine safety assessments, along with a trimonthly short form (36) Health Survey, opioid craving questionnaire, and Treatment Satisfaction Questionnaire for Medication. RESULTS: Of 49 opioid-dependent HCPs screened, 38 enrolled and received at least 1 XR-NTX injection. Most were female (n = 31) and nurses or nursing assistants (n = 30). More than half (n = 21; 55.3%) received at least 12 injections. Seven discontinued due to adverse events (3 anxiety, 2 headache, 1 injection-site mass, 1 derealization). None experienced relapses to opioid dependence necessitating detoxification, overdose, or death during treatment. At 24 months, mean opioid craving fell by 45.2%, and short form (36) mental component scores improved by 31.1% from baseline and approached normal levels. Of 22 unemployed subjects at baseline, 45.5% improved employment status at 24 months. CONCLUSIONS: Long-term (2 years) XR-NTX was associated with no new safety concerns, and, compared with shorter-term studies in the general population, similar or better rates of retention, opioid-negative urines, opioid craving reduction, mental health functional quality of life improvement, and re-employment.
PP - United States
PY - 2017
SN - 1935-3227; 1932-0620
SP - 224
EP - 230
EP - 
T1 - Open-label Study of Injectable Extended-release Naltrexone (XR-NTX) in Healthcare Professionals With Opioid Dependence
T2 - Journal of addiction medicine
TI - Open-label Study of Injectable Extended-release Naltrexone (XR-NTX) in Healthcare Professionals With Opioid Dependence
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 28358754
U3 - 10.1097/ADM.0000000000000302
VL - 11
VO - 1935-3227; 1932-0620
Y1 - 2017
Y2 - May/Jun
ER -