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Factors associated with using opiates while under extended-release naltrexone blockade: A descriptive pilot study.

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Patients using heroin/opiates while on extended-release naltrexone (XR-NTX) did not report feeling high or taking larger amounts. Concurrent cocaine use was common but typically via different administration routes.

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Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Clinical Psychology

Background:

  • Extended-release naltrexone (XR-NTX) is an opioid antagonist used in addiction treatment.
  • Despite XR-NTX blockade, some patients continue to use opioids, necessitating investigation into contributing factors.

Purpose of the Study:

  • To explore subjective effects and drug use patterns among patients using heroin/opiates while under XR-NTX blockade.
  • To understand reasons for continued opioid use despite pharmacological blockade.

Main Methods:

  • A subset of heroin-dependent adults (n=18) in an XR-NTX trial completed weekly surveys on recent opioid use.
  • Surveys assessed self-reported 'high' levels, opioid dosage relative to baseline, concurrent cocaine use, and routes of administration.

Main Results:

  • Most surveys (75.7%) reported no subjective high from heroin/opiates.
  • A majority (75.5%) reported using less opioid than usual; only 7.5% reported more.
  • Concurrent cocaine use occurred in 57.9% of instances, often via a different route (74.2%).

Conclusions:

  • Continued heroin/opiate use during XR-NTX blockade is not strongly linked to feeling high, increased dosage, or simultaneous opioid/cocaine use via the same route.
  • Future research should include naltrexone concentration and employ ecological momentary assessment for detailed insights.