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Randomized Controlled Trial
. 2015 Apr;24(3):258-264.
doi: 10.1111/ajad.12180.

Baseline characteristics of patients predicting suitability for rapid naltrexone induction

Shanthi Mogali  1 , Nabil A Khan  1 , Esther S Drill  2 , Martina Pavlicova  2 , Maria A Sullivan, Edward Nunes  1   3 , Adam Bisaga  1   3
Affiliations
Randomized Controlled Trial

Baseline characteristics of patients predicting suitability for rapid naltrexone induction

Shanthi Mogali et al. Am J Addict. 2015 Apr.

Abstract

Background and objectives: Extended-release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre-treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment.

Methods: A chart review of 150 consecutive research participants (N = 84 completers and N = 66 non-completers) undergoing a rapid naltrexone induction with the buprenorphone-clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction-detoxification.

Results: Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level.

Conclusions: Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone.

Scientific significance: Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction.

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Conflict of interest statement

Declaration of Interest

Dr. Mogali, Mr. Khan, Ms. Drill, Ms. Pavlicova, Dr. Sullivan, and Dr. Bisaga have no conflicts to declare.

Figures

FIGURE 1
FIGURE 1
A comparison of the distribution of bags/bag-equivalents of heroin used per day and age (years) between opioid- dependent patients who completed (N = 84), and those who failed to complete (N = 66), an inpatient rapid naltexone induction procedure.
See this image and copyright information in PMC

References

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