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Published on: January 29, 2017
Aversion to injection limits acceptability of extended-release naltrexone among homeless, alcohol-dependent patients
Peter D Friedmann1, Dawn Mello, Sean Lonergan
1Center on System, Outcomes & Quality in Chronic Disease & Rehabilitation, Research Service , Providence Veterans Affairs Medical Center , Providence , Rhode Island , USA. pfriedmann@lifespan.org
Background:
Ending homelessness is a major priority of the Department of Veteran Affairs (VA), and alcohol use can be a barrier to stable housing. Clinical trials suggest that depot extended-release naltrexone (XR-NTX) is efficacious in reducing alcohol consumption among alcohol-dependent subjects.
Methods:
An open-label, randomized pilot study sought to examine the feasibility and effectiveness of XR-NTX versus oral naltrexone to improve alcohol consumption and housing stability among homeless, alcohol-dependent veterans at the Providence Veteran Affairs Medical Center.
Results:
Of 215 potential candidates approached over a 16-month recruitment period, only 15 agreed to consider study entry and 7 were randomized. The primary reasons given for refusal were not wanting an injection; fear of needles; and not wanting to change drinking habits. Only 1 participant in the XR-NTX group returned after the first injection. Three participants in the oral naltrexone group attended all 7 visits and had good outcomes.
Conclusions:
Although XR-NTX has demonstrated efficacy in reducing heavy drinking, limited acceptance of the injection might reduce its effectiveness among homeless, alcohol-dependent patients.
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