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纳曲酮长效制剂的供应可能会增加接受治疗的阿片类药物依赖个体的数量:一项随机临床试验的延伸。

Availability of Extended-Release Naltrexone May Increase the Number of Opioid-Dependent Individuals in Treatment: Extension of a Randomized Clinical Trial.

机构信息

Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway,

Department of R&D in Mental Health, Akershus University Hospital, Loerenskog, Norway,

出版信息

Eur Addict Res. 2019;25(6):303-309. doi: 10.1159/000501931. Epub 2019 Jul 24.

Abstract

BACKGROUND AND OBJECTIVE

Opioid maintenance treatment (OMT) is highly available in Norway, but only 50% of opioid-dependent individuals are enrolled in such programs. This study was aimed at examining if availability of extended-release naltrexone (XR-NTX) could attract individuals who for different reasons were not enrolled in an OMT program.

METHODS

In a Norwegian clinical study, n = 117 opioid-dependent adults volunteered to receive XR-NTX in a 9-month period, as an extension of a previous randomized clinical trial.

RESULTS

Before study inclusion, 40.2% (n = 47) of the study participants were not enrolled in OMT while the remainder were recruited from OMT. Participants not enrolled in OMT displayed more ongoing severe addiction-related problems such as heroin use (p = 0.002), but displayed a higher retention in treatment in the 9-month extension study (p = 0.048 for log-rank test) than participants enrolled in OMT.

CONCLUSION

Availability of XR-NTX attracted opioid-dependent individuals not previously enrolled in OMT. While OMT may be perceived as a burden with regard to daily intake and control measures, one-monthly injections with XR-NTX may be perceived favourable, offering more freedom to the patients, not having addictive properties, and potentially reducing heroin craving. We suggest that an introduction of XR-NTX in Europe may increase the number of opioid-dependent individuals in treatment.

摘要

背景和目的

阿片类药物维持治疗(OMT)在挪威广泛应用,但只有 50%的阿片类药物依赖者参加了该项目。本研究旨在探讨延长释放型纳曲酮(XR-NTX)的可用性是否可以吸引由于各种原因未参加 OMT 项目的个体。

方法

在挪威的一项临床研究中,117 名成年阿片类药物依赖者自愿在 9 个月内接受 XR-NTX 治疗,作为先前随机临床试验的扩展。

结果

在研究纳入之前,40.2%(n=47)的研究参与者未参加 OMT,其余参与者则从 OMT 中招募。未参加 OMT 的参与者表现出更多持续存在的严重成瘾相关问题,如使用海洛因(p=0.002),但在 9 个月的扩展研究中,他们的治疗保留率更高(对数秩检验,p=0.048)。

结论

XR-NTX 的可用性吸引了以前未参加 OMT 的阿片类药物依赖者。虽然 OMT 可能被认为在日常摄入和控制措施方面是一种负担,但每月一次的 XR-NTX 注射可能被认为更有利,为患者提供更多自由,没有成瘾性,并可能减少海洛因渴望。我们建议,在欧洲引入 XR-NTX 可能会增加接受治疗的阿片类药物依赖者数量。

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