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Research Summary

Effectiveness and Feasibility of Extended-Release Naltrexone plus Medical Management in Primary Care: 15-Month Results

Extended-release naltrexone (XR-NTX) is safe and effective for the treatment of alcohol dependence and offers treatment-adherence advantages given its depot formation. The feasibility of implementing XR-NTX plus medical management into primary care practices was established in a previous 12-week observational study, but data regarding feasibility and efficacy past 24 weeks of treatment have been lacking. In this study, the authors investigated treatment retention, adverse-event rates, and enrollment in ancillary alcohol treatment (including 12-step programs) among patients enrolled in the extension phase of the initial study. Of 65 patients enrolled, 40 completed the first 12 weeks of treatment, and 19 continued on to the extension phase (median duration of treatment, 38 weeks [range, 16–72 weeks]; median total XR-NTX injections, 8).

  • No study-related adverse events were noted in the extension phase.
  • Ancillary alcohol treatment was endorsed by 11 of the 19 patients (58%).
  • Past 30-day self-reported drinking was 0.2 drinks per day versus 6 drinks per day at baseline; the rate of abstinent days was 82% versus 38%, and the rate of heavy drinking days was 11% versus 61%.

Comments:

Long-term combination treatment with XR-NTX and medical management is feasible in primary care practice. Although efficacy is suggested in this observational single-arm study, experimental studies are needed to lend further support to implementation of XR-NTX in primary care practice. Jeanette M. Tetrault, MD

Reference:

Lee JD, Grossman E, Huben L, et al. Extended-release naltrexone plus medical management alcohol treatment in primary care: findings at 15 months. J Subst Abuse Treat. 2012;43(4):458–462.

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