Category: Federal Forum Posters
Purpose: Naltrexone is an opioid antagonist which can be given orally or by extended-release intramuscular injection to prevent opioid relapse. There is data to support intramuscular naltrexone having a similar safety and efficacy profile to buprenorphine-naloxone in patients with opioid use disorder. Based on the data to support clinical efficacy of intramuscular naltrexone along with its ability to be dosed only once every twenty-eight days, it is a good, and potentially underutilized, option for the treatment of opioid use disorder. The purpose of this study is to evaluate the clinical efficacy of intramuscular naltrexone for the treatment of opioid use disorder.
Methods: The institutional review board granted a quality improvement exemption approval for this retrospective, mirror-image evaluation. Patients who received an inpatient or outpatient medication order for intramuscular naltrexone between the dates of July 1, 2017 and June 30, 2018 were considered for inclusion in this study. Patients receiving intramuscular naltrexone solely for a diagnosis of alcohol use disorder or alcohol dependence were excluded from this evaluation. Data was collected using the Veterans Affairs’ Computerized Patient Record System (CPRS) and included patient demographics, urine fentanyl screen, urine opiate screen, urine oxycodone screen, urine methadone screen, intramuscular naltrexone administration dates, and hospital admissions for detoxification and/or overdose from opioids. Urine toxicology screening was analyzed as a mirror-image study. The primary outcome was the number of positive urine drug screens after initiation of intramuscular naltrexone compared to prior to initiation as a surrogate marker of efficacy. Hospital admissions related to opioid use were evaluated to assess for relapse while on naltrexone therapy. The collected information was analyzed to determine the degree of clinical improvement in opioid use disorder after initiation of intramuscular naltrexone.
Results: Not applicable
Conclusion: Not applicable
Melissa Wright– Student, University of Connecticut, Middletown, CT