Extended-Release Naltrexone During Inpatient Detoxification: Opportunity for Linkage to Ongoing Care

Inpatient detoxification programs are often the first foray into treatment for many patients with opioid use disorder (OUD). However, linkage to and retention in aftercare programs continue to pose major barriers. One option to improve outcomes includes initiation of extended-release naltrexone (XR-NTX) during inpatient treatment (requiring an additional stay in the inpatient setting after completion of an opioid agonist detoxification) with linkage to office-based follow-up for ongoing XR-NTX treatment. Researchers examined follow-up rates of patients who received XR-NTX following detoxification and determined factors associated with receipt of a second injection during primary care follow-up.

• Mean age of the study sample was 32 (± 8) years of age; 90% were non-Latino Caucasian; 94% reported heroin as primary opioid of use.
• Of 62 patients who chose to receive an initial dose of XR-NTX during inpatient detoxification, 55% received a second injection during primary care follow-up, 32% received a third injection, and 23% received ≥4 injections.
• No demographic or clinical variables were associated with receipt of a second injection.

Comments:

The data reported in this study come from a single site, lack a control group and information on substance use. Nonetheless, over half of patients who opted to stay an additional 10 days in inpatient treatment to receive XR-NTX followed up in primary care to receive a second injection. This model presents a unique opportunity to engage motivated patients with OUD in ongoing treatment.

Jeanette M. Tetrault, MD

Reference:

Stein MD, Risi MM, Bailey GL, Anderson BJ. Linkage to primary care for persons first receiving injectable naltrexone during inpatient opioid detoxification. J Subst Abuse Treat. 2016;64:44–46.