The following article is part of The Clinical Advisor’s coverage from the 2018 American Association of Nurse Practitioners’ annual meeting in Denver. Our staff will be reporting live on original research, case studies, and professional outreach and advocacy news from leading NPs in various therapeutic areas. Check back for ongoing updates from AANP 2018. 

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.

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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.

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

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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.