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Factors associated with receipt of second injection of naltrexone for opioid use disorder: Secondary analysis of 5

Matisyahu Shulman1, Mei-Chen Hu2, Maria A Sullivan3

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|June 8, 2025
PubMed
Summary
This summary is machine-generated.

Patients receiving extended-release injectable naltrexone (XR-naltrexone) for opioid use disorder (OUD) who have lower depressive symptoms after the first injection are more likely to receive a second injection. Monitoring depression is key for OUD treatment retention.

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Area of Science:

  • Addiction Medicine
  • Psychopharmacology
  • Clinical Psychology

Background:

  • Extended-release injectable naltrexone (XR-naltrexone) is an effective treatment for opioid use disorder (OUD).
  • Patient retention in XR-naltrexone treatment is a significant challenge.
  • Limited research exists on predictors of early retention using comprehensive datasets.

Purpose of the Study:

  • To identify baseline and clinical predictors associated with early retention on XR-naltrexone.
  • To analyze factors influencing the receipt of a second XR-naltrexone injection in patients with active opioid use.

Main Methods:

  • A combined dataset from five studies enrolling patients with active opioid use was analyzed (n=200).
  • Bivariate associations between baseline and post-injection characteristics and receipt of a second injection were calculated.
  • A multivariable logistic regression model was used to identify significant predictors.

Main Results:

  • 74% of participants received a second injection.
  • Lower Hamilton-Depression Scale (HAM-D) scores post-injection were significantly associated with receiving a second injection.
  • Univariate analysis identified other factors like prior abstinence, substance use, and lower craving/withdrawal scores, but these were not significant in the multivariable model.

Conclusions:

  • Depressive symptoms following the first XR-naltrexone injection are linked to poorer treatment retention.
  • Clinicians should counsel patients on the risk of depression and actively monitor for symptoms post-injection.
  • Early identification and management of depression may improve XR-naltrexone treatment adherence in OUD patients.