SynthesisAddiction (Abingdon, England)2018
Extended-release injectable naltrexone for opioid use disorder: a systematic review.
Synthesis in Addiction (Abingdon, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 9 syntheses or guidelines pooled it, 212 citations in OpenAlex.
- Factors associated with the percentage of individuals who initiate and discontinue naltrexone as a relapse prevention pharmacotherapy in opioid use disorder: A systematic review, meta-analysis and meta-regression.Addiction (Abingdon, England) · 2026Pooled it
- Effectiveness of Alcohol Use Disorder Pharmacotherapies by Sex: Systematic Review and Meta-Analysis.Drug and alcohol review · 2026Pooled it
- Sustained-release naltrexone for opioid dependence.The Cochrane database of systematic reviews · 2025Pooled it
- The effects of naltrexone on retention in treatment and being opioid-free in opioid-dependent people: A systematic review and meta-analysis.Frontiers in psychiatry · 2022Pooled it
- Pooled it
- Diversity inclusion in United States opioid pharmacological treatment trials: A systematic review.Experimental and clinical psychopharmacology · 2021Pooled it
- Global patterns of opioid use and dependence: harms to populations, interventions, and future action.Lancet (London, England) · 2019Pooled it
- Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.Addiction science & clinical practice · 2019Pooled it
- A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature.Journal of addictions nursingPooled it
- Beneficial effects of the rapid vs. standard procedure for injection naltrexone initiation operate through increased adjunctive medication use.Drug and alcohol dependence · 2026Trial
- Thresholds for adjunctive medication usage and probability of initiating injectable naltrexone.Addiction (Abingdon, England) · 2026Trial
- Effect of Relaxation-Based Virtual Reality on Psychological and Physiological Stress of Substance Abusers Under Detoxification: A Randomized Controlled Trial.Brain and behavior · 2024Trial
- Rapid Initiation of Injection Naltrexone for Opioid Use Disorder: A Stepped-Wedge Cluster Randomized Clinical Trial.JAMA network open · 2024Trial
- Health care use and cost of treatment for adolescents and young adults with opioid use disorder.Journal of substance use and addiction treatment · 2023Trial
- Cost-effectiveness of extended-release injectable naltrexone among incarcerated persons with opioid use disorder before release from prison versus after release.Journal of substance abuse treatment · 2022Trial
- Patients' experiences of continued treatment with extended-release naltrexone: a Norwegian qualitative study.Addiction science & clinical practice · 2022Trial
- HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.Addiction (Abingdon, England) · 2022Trial
- Prescribers' satisfaction with delivering medications for opioid use disorder.Substance abuse treatment, prevention, and policy · 2021Trial
- Remotely delivered incentives to promote buprenorphine treatment engagement in out-of-treatment adults with opioid use disorder.Drug and alcohol dependence · 2021Trial
- A randomized comparison of extended-release naltrexone with or without patient navigation vs enhanced treatment-as-usual for incarcerated adults with opioid use disorder.Journal of substance abuse treatment · 2020Trial
50 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
aimsTo review systematically the published literature on extended-release naltrexone (XR-NTX, Vivitrol
methodsWe searched PubMed and used Google Scholar for forward citation searches of peer-reviewed papers from January 2006 to June 2017. Studies that included individuals seeking treatment for opioid use disorder who were offered XR-NTX were included.
resultsWe identified and included 34 studies. Pooled estimates showed that XR-NTX induction success was lower in studies that included individuals that required opioid detoxification [62.6%, 95% confidence interval (CI) = 54.5-70.0%] compared with studies that included individuals already detoxified from opioids (85.0%, 95% CI = 78.0-90.1%); 44.2% (95% CI = 33.1-55.9%) of individuals took all scheduled injections of XR-NTX, which were usually six or fewer. Adherence was higher in prospective investigational studies (i.e. studies conducted in a research context according to a study protocol) compared to retrospective studies of medical records taken from routine care (6-month rates: 46.7%, 95% CI = 34.5-59.2% versus 10.5%, 95% CI = 4.6-22.4%, respectively). Compared with referral to treatment, XR-NTX reduced opioid use in adults under criminal justice supervision and when administered to inmates before release. XR-NTX reduced opioid use compared with placebo in Russian adults, but this effect was confounded by differential retention between study groups. XR-NTX showed similar efficacy to buprenorphine when randomization occurred after detoxification, but was inferior to buprenorphine when randomization occurred prior to detoxification.
conclusionsMany individuals intending to start extended-release naltrexone (XR-NTX) do not and most who do start XR-NTX discontinue treatment prematurely, two factors that limit its clinical utility significantly. XR-NTX appears to decrease opioid use but there are few experimental demonstrations of this effect.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.