Risk of relapse to non-opioid addictive substances among opioid dependent patients treated with an opioid receptor antagonist or a partial agonist: A randomized clinical trial
Opheim, Arild; Saltyte Benth, Jurate; Solli, Kristin Klemmetsby; Kloster, Pia Synnøve; Fadnes, Lars T.; Kunøe, Nikolaj; Gaulen, Zhanna; Tanum, Lars Håkon Reiestad
Peer reviewed, Journal article
Published version
Permanent lenke
https://hdl.handle.net/11250/3109844Utgivelsesdato
2023Metadata
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Originalversjon
10.1016/j.cct.2023.107360Sammendrag
ackground and objective: First study to assess any compensatory increase in use of non-opioid illicit substances
and alcohol in opioid dependent patients randomized to treatment with extended-release naltrexone (XR-NTX) or
buprenorphine-naloxone (BP-NLX) and in longer term treatment with extended-release naltrexone.
Method: A multicenter, outpatient, open-label randomized clinical trial where patients received intramuscular
extended-release naltrexone hydrochloride, 380 mg/month, or daily sublingual buprenorphine-naloxone 8–24/
2–6 mg for 12 weeks, and an option to continue with extended-release naltrexone for an additional 36 week
follow-up. The study was conducted at five urban addiction clinics and detoxification units in Norway between
November 2012, and July 2016.
Results: Among the 143 patients, 106 men and 37 women, there were no significant differences between those
randomized to XR-NTX or BP-NLX in the risk of first relapse to alcohol (HR 1.31; 0.68–2.53), amphetamines (HR
0.88; 0.43–1.80), benzodiazepines (HR 1.24; 0.74–2.09) or cannabis (HR 1.55; 0.83–2.89). Also in the 36-week
(12–48 weeks) follow-up period we found no significant differences between patients continuing with XR-NTX
compared to those switching to XR-NTX after the randomized period in risk of first relapse to any non-opioid
substance. In both study periods, the mean time in the study were longer among those relapsing to non-
opioid addictive substances than those who did not. There was no significant association between first relapse
to illicit opioids and first relapse to non-opioid addictive substances.
Conclusion: There was no increase in the risk of relapse to non-opioid addictive substances neither in short term
nor longer-term treatment with extended-release naltrexone.