A Recent Open Label Pilot Study

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In a recent open-label pilot study by Mannelli, et al. (2014), it was examined whether or not patients can be safely and effectively administered XR-NTX after using opioids by using oral naltrexone and buprenorphine to mediate the transition. The 20 participants included in the study were administered naltrexone (days 1–7), buprenorphine (days 1–3), and a single 380mg injection of XR-NTX (day 8), with scheduled assessment visits on days 1-9 and then weekly through week 4. Fifteen of 20 participants successfully concluded the induction phase (day 7), and 14 received XR-NTX (day 8). Opioid withdrawal and narcotic craving from day 1 of the study were measured using the Subjective Opiate Withdrawal Scale (SOWS), Clinical Opiate Withdrawal…show more content…
By the fourth week, the percent of positive drug screens dropped to 33.3% in the XR-NTX treatment group versus the baseline percent (not shown) (x2=7.41; p=0.001). Adherence is crucial to treatment efficacy, and Defulio, et al. (2012) examined a means to increase XR-NTX treatment adherence via employment-based reinforcement in opioid dependent persons (n=38) in a randomized, controlled trial. The participants were randomized into contingency (n=19) or prescription condition groups (n=19). Participants received up to six monthly doses of XR-NTX over the course of 24 weeks. In order for the contingency group participants to be able to access the designated workplace, they were required to accept XR-NTX injections, however, prescription participants could gain access without being administered XR-NTX injections. Significance was found in contingency participants were being retained greater than prescription participants (x2=7.11, p=0.008; HR=0.27, 95% CI: 0.1–0.71). By the end of the trial, 74% of contingency participants versus 26% of prescription participants received all of the XR-NTX injections (x2=8.53, p=0.004). In a moderator analysis, Nunes, et al. (2015) tried to identify which individuals are most likely to respond to treatment with XR-NTX. The analysis used the findings of the previously mentioned study by
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