Transition to Naltrexone in Opioid Use Disorder Benefits from Psychosocial Assessment

DENVER – Successfully transitioning patients with opioid use disorder to extended-release naltrexone requires consideration of both the medical and psychosocial needs of the patient, according to research presented at the American Association of Nurse Practitioners 2018 National Conference.

A review of evidence-based outpatient/inpatient protocols that support transition from active opioid use/buprenorphine maintenance to extended-release naltrexone was conducted. The investigators also studied an induction procedure that uses a buprenorphine taper in conjunction with or prior to ascending doses of oral naltrexone, usually administered over the course of 7 to 10 days.

The researchers found that pairing psychoeducational counseling with induction procedures resulted in initiation of extended-release naltrexone with no serious adverse events in 50% to 70% of participants with opioid use disorder. Although some participants experienced sleep disturbances, low energy, anxiety, irritability, and diarrhea when initially starting naltrexone, most symptoms resolved within 3 to 4 weeks.

“Advanced practice nurses are in a unique position to play a central role in the provision of medication-assisted treatment for [opioid-use disorder] and in shaping patients’ experiences in the transition to [extended-release naltrexone], so as to maximize adherence and successful treatment outcomes,” the researchers wrote.

Disclosure: This literature review was supported by Alkermes, Inc.

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Reference

Speight L, Zavod A, Compton P, et al. Transition to extended-release naltrexone (XR-NTX) in opioid use disorder. Presented at the American Association of Nurse Practitioners 2018 National Conference. June 26-July 1, 2018; Denver, CO. Poster 23.