Premium
Baseline characteristics of patients predicting suitability for rapid naltrexone induction
Author(s) -
Mogali Shanthi,
Khan Nabil A.,
Drill Esther S.,
Pavlicova Martina,
Sullivan Maria A.,
Nunes Edward,
Bisaga Adam
Publication year - 2015
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/ajad.12180
Subject(s) - naltrexone , medicine , opioid , anesthesia , confidence interval , heroin , logistic regression , psychology , psychiatry , drug , receptor
Background and Objectives Extended‐release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre‐treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment. Methods A chart review of 150 consecutive research participants ( N = 84 completers and N = 66 non‐completers) undergoing a rapid naltrexone induction with the buprenorphone‐clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction‐detoxification. Results Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level. Conclusions Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone. Scientific Significance Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction. (Am J Addict 2015;24:258–264)