Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway; Department of Clinical Dentistry, University of Bergen, Årstadveien 19, 5009 Bergen, Norway.
Institute of Clinical Medicine, Campus Ahus, University of Oslo, Blindern, Problemveien 7, 0315, Norway; Health Services Research Unit, Akershus University Hospital, Lørenskog, Sykehusveien 25, 1478 Nordbyhagen, Norway.
J Subst Abuse Treat. 2022 Apr;135:108656. doi: 10.1016/j.jsat.2021.108656. Epub 2021 Nov 9.
Life satisfaction (LS) in opioid-dependent individuals is lower than in the general population. This study aimed to explore changes in LS during short- and long-term treatment with extended-release naltrexone (XR-NTX).
This open-label 12-week clinical trial randomized 159 participants to either monthly XR-NTX or daily buprenorphine-naloxone (BP-NLX). In a subsequent 36-week follow-up study on XR-NTX, participants either continued or switched to XR-NTX. The study collected data on the Temporary Satisfaction with Life (TSWL) and illicit opioid use every fourth week. The research team assessed changes in TSWL by a linear mixed model and growth mixture model. The study assessed relationship between opioid use and TSWL by a linear mixed model.
Change in LS differed significantly between the groups in both study periods. TSWL scores were significantly higher in the XR-NTX group at week 4 (p = 0.013) and week 8 (p = 0.002). In the follow-up period, the groups were significantly different only at week 16 (p = 0.031) and week 48 (p = 0.025), with the higher TSWL scores in the XR-NTX continued group. Increase in opioid use by one day was associated with a 0.12 point lower mean TSWL score. Both study periods identified groups with low and high LS levels. In the trial period, the TSWL scores exhibited a significant increase from baseline to week 12 in both groups, p < 0.001 and p = 0.011 in the low and high LS group, respectively. In the follow-up period, the TSWL scores exhibited a significant increase from week 16 to week 48 (p = 0.003) in the high LS group, while the low LS group showed persistently lower values throughout that period.
XR-NTX treatment given once monthly is associated with higher LS, as measured by TSWL, compared to daily use of BP-NLX. The majority of the participants had relatively low TSWL scores and did not report any change in TSWL during longer-term treatment. The study found a significant association between more frequent illicit opioid use and a low or decreased LS during follow-up.
阿片类药物依赖者的生活满意度（LS）低于一般人群。本研究旨在探讨长期使用缓释纳曲酮（XR-NTX）治疗对 LS 的影响。
本开放性 12 周临床试验将 159 名参与者随机分为每月 XR-NTX 组或每日丁丙诺啡-纳洛酮（BP-NLX）组。在 XR-NTX 的后续 36 周随访研究中，参与者继续或转换为 XR-NTX。研究每四周收集一次临时生活满意度量表（TSWL）和非法阿片类药物使用情况的数据。研究团队通过线性混合模型和增长混合模型评估 TSWL 的变化。研究团队通过线性混合模型评估阿片类药物使用与 TSWL 之间的关系。
在两个研究期间，LS 的变化在两组之间有显著差异。XR-NTX 组在第 4 周（p=0.013）和第 8 周（p=0.002）的 TSWL 评分显著升高。在随访期间，仅在第 16 周（p=0.031）和第 48 周（p=0.025）两组之间存在显著差异，XR-NTX 持续组的 TSWL 评分较高。阿片类药物使用量增加一天，平均 TSWL 评分就会降低 0.12 分。两个研究期间都确定了 LS 水平较低和较高的组。在试验期间，两组的 TSWL 评分在基线至第 12 周都有显著升高（p<0.001），低 LS 组和高 LS 组分别为 p=0.011 和 p=0.011。在随访期间，高 LS 组的 TSWL 评分从第 16 周到第 48 周显著升高（p=0.003），而低 LS 组在整个期间一直保持较低水平。
与每日使用丁丙诺啡-纳洛酮相比，每月一次使用缓释纳曲酮治疗与更高的 LS（以 TSWL 衡量）相关。大多数参与者的 TSWL 评分相对较低，并且在长期治疗期间没有报告 TSWL 有任何变化。研究发现，在随访期间，非法阿片类药物使用频率越高，LS 越低或越低。
