Trial reportAddiction (Abingdon, England)2020
Opioid use and dropout from extended-release naltrexone in a controlled trial: implications for mechanism.
Trial report in Addiction (Abingdon, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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
12 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- Patient Characteristics Associated with Opioid Abstinence after Participation in a Trial of Buprenorphine versus Injectable Naltrexone.Substance use & misuse · 2022Trial
- Review
- Medications for OUD: Extended-Release Naltrexone.Current addiction reports · 2025Article
- Association between body mass index and treatment completion in extended-release naltrexone-treated patients with opioid dependence.Frontiers in psychiatry · 2023Article
- Contextual extinction of drug-associated discriminative stimuli fails to attenuate drug-vs-food choice in rhesus monkeys.Journal of the experimental analysis of behavior · 2022Article
- Levels of Impulsivity, Hyperactivity, and Inattention and the Association with Mental Health and Substance Use Severity in Opioid-Dependent Patients Seeking Treatment with Extended-Release Naltrexone.Journal of clinical medicine · 2021Article
- Medications Development for Treatment of Opioid Use Disorder.Cold Spring Harbor perspectives in medicine · 2021Review
- Reply to Kunoe (2020) and Ghosh & Singh (2020) regarding Nunes et al. (2020): Opioid use and dropout from extended-release naltrexone in a controlled trial: implications for mechanism.Addiction (Abingdon, England) · 2020Article
- Evaluation of a Dual Fentanyl/Heroin Vaccine on the Antinociceptive and Reinforcing Effects of a Fentanyl/Heroin Mixture in Male and Female Rats.ACS chemical neuroscience · 2020Article
- Preclinical Evaluation of Vaccines to Treat Opioid Use Disorders: How Close are We to a Clinically Viable Therapeutic?CNS drugs · 2020Review
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Authors and funding
7 authors.
Funding
Abstract
BACKGROUND AND
aimsExtended-release formulations of naltrexone have emerged as effective treatment options for opioid use disorder. This post-hoc analysis examined the temporal relationship between episodes of opioid use and subsequent dropout in a placebo-controlled trial of extended-release injection naltrexone (XR-NTX) to draw inferences about the mechanism by which extended blockade of opioid receptors translates into clinical effectiveness.
designThis was a 24-week multiple-site, double-blind, randomized trial of monthly XR-NTX versus placebo injections. We analyzed time to dropout from treatment using survival analysis with an extended Cox model as a function of treatment (XR-NTX versus placebo) and with weekly urine drug test (UDT) results for opioids at each week as a time-dependent covariate.
settingThirteen addiction treatment programs in Russia, 2008-09.
participantsA total of 250 adults with opioid use disorder who had completed in-patient detoxification.
interventionXR-NTX injection or placebo injection every 4 weeks with weekly clinic visits and biweekly counseling. MEASUREMENTS: Urine toxicology for opioids measured weekly and week of dropout from treatment.
findingsThe Cox model yielded a significant interaction of time-dependent urine toxicology by treatment (P = 0.024). Among patients receiving placebo, a positive UDT in a given week increased the risk for dropout from treatment in the subsequent week [hazard ratio (HR) = 6.25; 95% confidence interval (CI) = 3.6-10.0], whereas among patients receiving XR-NTX, a positive UDT result showed no significant effect on risk for dropout (HR = 1.67; 95% CI = 0.6-4.5). The proportion of patients who completed all 24 weeks without any positive UDT result was 31% on XR-NTX compared with 20% on placebo (P = 0.051).
conclusionsExtended-release injection naltrexone was effective at reducing the risk of dropout from opioid use disorder treatment after an episode of opioid use. Just under a third of patients (31%) on XR-NTX had no opioid-positive urine tests across the trial, but the hypothesis that this would differ from placebo (20%) was not confirmed.
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