Extended Release Naltrexone AIDS in Prevention of Relapse to Opioid Dependence

The problem of prescription drug abuse has turned macabre with prescription painkillers like OxyContin, Vicodin, Percocet and street drug heroin killing more than 28,000 people in the United States in 2014 alone, according to the Centers for Disease Control and Prevention (CDC) data.

Fighting the epidemic of addiction and overdose of prescription drugs and heroin has been one of the prime concerns of the federal government. And in this fight, naltrexone – a comparatively new anti-addiction drug – has been quite effective in curbing prescription drug abuse and heroin addiction.

According to a new study, published in the New England Journal of Medicine, an extended release naltrexone – a sustained release monthly injectable formulation of the full mu-opioid receptor antagonist – is effective for the prevention of relapse to opioid dependence.

The researchers found that monthly injections of extended release naltrexone can block the euphoric effects of opioids. They found that it also resulted in a significant drop in relapse rate among treated addicts when pitted against a similar group of patients who were not administered the drug. Moreover, there were no overdoses in the naltrexone group compared to five in the other group during the six-month study.

Study finds lower relapse rate in addicts who were given naltrexone.

The investigators selected five sites in four major U.S. cities to conduct their trial. They selected two groups for this study. One of the groups had 153 opioid addicted adults with some sort of criminal justice involved, while the other group had 155 participants who did not receive the naltrexone but a brief intervention like counseling and referrals to community programs. After six months, 43 percent of the people injected with naltrexone relapsed while from the group which did not receive the medication the relapse rate was 64 percent.

“The primary outcome was the time to an opioid-relapse event, which was defined as 10 or more days of opioid use in a 28-day period as assessed by self-report or by testing of urine samples obtained every 2 weeks; a positive or missing sample was computed as 5 days of opioid use. Post-treatment follow-up occurred at weeks 27, 52, and 78,” the researchers noted in the study.

A year after the treatment ended, they conducted a follow-up and both the groups were found using opioids at a similar rate. However, two additional overdoses had occurred in the non-naltrexone group and none in the treatment group. This proves the benefits of administering naltrexone to addicts.

The study revealed that extended release naltrexone resulted in a lower rate of opioid relapse than the rate with usual treatment in participants. However, the researchers did not notice any benefit of extended release naltrexone on several important secondary outcomes, including rates of cocaine, heavy alcohol, and injection drug use. What the researchers noticed was that opioid use prevention effects waned after treatment discontinuation.

The researchers thus concluded that naltrexone can actually help in preventing relapse in individuals undergoing opioid treatment, and can curb dependence on heroin and prescription painkillers. Naltrexone can sure play a major role in alleviating America’s opioid abuse epidemic to a great extent.