Extended-release naltrexone (XR-NTX) for opioid use disorder in clinical practice: Vivitrol's Cost and Treatment Outcomes Registry

Addiction ◽  
2018 ◽  
Vol 113 (8) ◽  
pp. 1477-1487 ◽  
Author(s):  
Andrew J. Saxon ◽  
Sarah C. Akerman ◽  
Chih-Chin Liu ◽  
Maria A. Sullivan ◽  
Bernard L. Silverman ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Outcomes ◽  
Extended Release ◽  
Opioid Use Disorder ◽  
Opioid Use

Treatment Outcomes in Individuals Diagnosed with Comorbid Opioid Use Disorder and Posttraumatic Stress Disorder: A Review

2021 ◽  
pp. 107026
Author(s):  
Sarah Meshberg-Cohen ◽  
R. Ross MacLean ◽  
Ashley M. Schnakenberg Martin ◽  
Mehmet Sofuoglu ◽  
Ismene L. Petrakis
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Prior National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder trials as background and rationale for NIDA CTN-0100 “optimizing retention, duration and discontinuation strategies for opioid use disorder pharmacotherapy (RDD)”

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Matisyahu Shulman ◽  
Roger Weiss ◽  
John Rotrosen ◽  
Patricia Novo ◽  
Elizabeth Costello ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Extended Release ◽  
Primary Outcome ◽  
Opioid Use Disorder ◽  
Drug Abuse Treatment ◽  
Opioid Use ◽  
National Drug ◽  
Retention In Treatment ◽  
Abuse Treatment

AbstractOpioid use disorder continues to be a significant problem in the United States and worldwide. Three medications—methadone, buprenorphine, and extended-release injectable naltrexone,— are efficacious for treating opioid use disorder (OUD). However, the utility of these medications is limited, in part due to poor rates of retention in treatment. In addition, minimum recovery milestones and other factors that influence when and whether individuals can safely discontinue medications are unknown. The National Drug Abuse Treatment Clinical Trials Network (CTN) study “Optimizing Retention, Duration, and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy” (RDD; CTN-0100) will be among the largest clinical trials on treatment of OUD yet conducted, consisting of two phases, the Retention phase, and the Duration-Discontinuation phase. The Retention phase, open to patients initiating treatment, will test different doses and formulations of buprenorphine (standard dose sublingual, high dose sublingual, or extended-release injection), and a digital therapeutic app delivering contingency management and cognitive behavioral counseling on the primary outcome of retention in treatment. The Discontinuation phase, open to patients in stable remission from OUD and choosing to discontinue medication (including participants from the Retention phase or from the population of patients treated at the clinical site, referred by an outside prescriber or self-referred) will study different tapering strategies for buprenorphine (sublingual taper vs taper with injection buprenorphine), and a digital therapeutic app which provides resources to promote recovery, on the primary outcome of relapse-free discontinuation of medication. This paper describes how the RDD trial derives from two decades of research in the CTN. Initial trials (CTN-0001; CTN-0002; CTN-0003) focused on opioid detoxification, showing buprenorphine-naloxone was effective for detoxification, but that acute detoxification did not appear to be an effective treatment strategy. Trials on comparative effectiveness of medications for opioid use disorder (MOUD) (CTN-0027; CTN-0030; and CTN-0051) highlighted the problem of dropout from treatment and few trials defined retention on MOUD as the primary outcome. Long-term follow-up studies on those patient samples demonstrated the importance of long-term continuation of medication for many patients to sustain remission. Overall, these trials highlight the potential of a stable research infrastructure such as CTN to advance treatment effectiveness through a programmatic succession of large clinical trials.

scholarly journals What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report

2021 ◽  
Vol 18 (4) ◽  
pp. 1425
Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Opioid Use Disorder ◽  
Term Treatment ◽  
Pharmacological Therapy ◽  
Daily Clinical Practice ◽  
Short Report ◽  
Opioid Use ◽  
Cross Sectional ◽  
Long Term Treatment ◽  
Social Profiles

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.

The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

2021 ◽  
Author(s):  
R. Ross MacLean ◽  
Suzanne Spinola ◽  
Gabriella Garcia-Vassallo ◽  
Mehmet Sofuoglu
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Disorder Treatment ◽  
The Impact

scholarly journals Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0181927 ◽  
Author(s):  
Andrew Ross ◽  
Justin Rankin ◽  
Jason Beaman ◽  
Kelly Murray ◽  
Philip Sinnett ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals The role of social network support in treatment outcomes for medication for opioid use disorder: a systematic review

2020 ◽  
Author(s):  
Navin Kumar ◽  
William Oles ◽  
Benjamin A. Howell ◽  
Kamila Janmohamed ◽  
Selena T. Lee ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Social Connections ◽  
Opioid Use ◽  
Network Support ◽  
Social Network Support ◽  
Partner Relationships

AbstractBackgroundSocial connections can lead to contagion of healthy behaviors. Successful treatment of patients with opioid use disorder, as well as recovery of their communities from the opioid epidemic, may lay in rebuilding social networks. Strong social networks of support can reinforce the benefits of medication treatments that are the current standard of care and the most effective tool physicians have to fight the opioid epidemic.MethodsWe conducted a systematic review of electronic research databases, specialist journals and grey literature up to August 2020 to identify experimental and observational studies of social network support in patient populations receiving medication for opioid use disorder (MOUD). We place the studies into a conceptual framework of dynamic social networks, examining the role of networks before MOUD treatment is initiated, during the treatment, and in the long-term following the treatment. We analyze the results across three sources of social network support: partner relationships, family, and peer networks. We also consider the impact of negative social connections.ResultsOf 5193 articles screened, 46 studies were identified as meeting inclusion criteria (12 were experimental and 34 were observational). 39 studies indicated that social network support, or lack thereof, had a statistically significant relationship with improved MOUD treatment outcomes. We find the strongest support for the positive impact of family and partner relationships when integrated into treatment attempts. We also identify strong evidence for a negative impact of maintaining contacts with the drug-using network on treatment outcomes.ConclusionsSocial networks significantly shape effectiveness of opioid use disorder treatments. While negative social ties reinforce addiction, positive social support networks can amplify the benefits of medication treatments. Targeted interventions to reconstruct social networks can be designed as a part of medication treatment with their effects evaluated in improving patients’ odds of recovery from opioid use disorder and reversing the rising trend in opioid deaths.

Dual diagnosis inpatient treatment outcomes for individuals with co-occurring chronic pain and opioid use disorder

2018 ◽  
Vol 19 (3) ◽  
pp. S32
Author(s):  
C. Cutter ◽  
F. Buono ◽  
S. Ackerman ◽  
M. Brennan ◽  
D. Mueller ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Dual Diagnosis ◽  
Inpatient Treatment ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Beyond Antibiotics: A Practical Guide for the Infectious Disease Physician to Treat Opioid Use Disorder in the Setting of Associated Infectious Diseases

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Nikhil Seval ◽  
Ellen Eaton ◽  
Sandra A Springer
Keyword(s):  
Infectious Disease ◽  
Extended Release ◽  
Hospital Admissions ◽  
Opioid Use Disorder ◽  
Evidence Based ◽  
Opioid Use ◽  
Patient Centered ◽  
Infectious Disease Physician ◽  
Centered Care ◽  
Acute Injection

Abstract Infections are a common cause of hospitalization for patients with opioid use disorder (OUD), and hospital admissions are rising in the context of the worsening US opioid crisis. Infectious disease (ID) physicians are frequently the first point of medical contact for these patients. In this article, we discuss the integration of evidence-based management of OUD and patient-centered care of hospitalized persons with acute injection-related infections. We describe the following components of a comprehensive approach for OUD with inpatient ID consultations: (1) how to screen for OUD; (2) how to initiate the 3 US Food and Drug Administration-approved medications for OUD (buprenorphine, methadone, and extended-release naltrexone); (3) how to manage acute pain and opioid-related conditions; and (4) how to link and integrate ID and OUD treatment after hospital discharge. These strategies reduce unplanned discharges and increase completion of recommended antimicrobial regimens.

Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder

2018 ◽  
Vol 25 (4) ◽  
pp. 272-279
Author(s):  
Abigail Zavod ◽  
Sarah C. Akerman ◽  
Martha M. Snow ◽  
Matt Tierney ◽  
Maria A. Sullivan
Keyword(s):  
Treatment Adherence ◽  
Extended Release ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Opioid Use ◽  
Major Barrier ◽  
Supportive Interventions ◽  
Outpatient Utilization ◽  
Withdrawal Management

BACKGROUND: The United States is experiencing an opioid epidemic. Better approaches to encourage outpatient utilization of Food and Drug Administration–approved medications for the treatment of opioid use disorder, including extended-release naltrexone (XR-NTX), are needed. Withdrawal management before initiation of XR-NTX is challenging for clinicians and patients and represents a major barrier to treatment. AIMS: To review psychoeducational strategies that support patients during outpatient withdrawal management and transition to XR-NTX. METHOD: We reviewed the literature on psychoeducational strategies used during opioid withdrawal management and described the role that nurses can play in facilitating transition to XR-NTX in a Phase 3, placebo-controlled, outpatient trial comparing induction regimens. RESULTS: Supportive interventions include general psychoeducation on addiction, overcoming ambivalence, treatment adherence, anticipating XR-NTX induction, managing psychological and physiological aspects of opioid withdrawal, risks of opioid use, and sources of support during recovery. CONCLUSIONS: Psychoeducational strategies led by nurses can promote treatment adherence during withdrawal management and induction onto XR-NTX.

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