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Rapid Initiation Procedure may Improve XR-Naltrexone Efficacy among Opioid Use Disorder: JAMA
A recent study has revealed a promising approach to expanding access to effective treatment against opioid use disorder (OUD). The research compared two procedures for initiating extended-release (XR)-naltrexone which is a key medication in OUD management. The major findings of the study were published in the Journal of American Medical Association.
This study was conducted at six community-based inpatient addiction treatment units to address a significant barrier to XR-naltrexone implementation and the need for patients to undergo opioid withdrawal prior to treatment initiation. This requirement often discourages individuals from seeking XR-naltrexone therapy.
The study spanned from March 16, 2021 to September 21, 2022 and focused on comparing the effectiveness of the standard procedure (SP) with a novel approach termed the rapid procedure (RP). As per XR-naltrexone package instructions, the SP involved a multi-day buprenorphine taper followed by an opioid-free period. The RP condensed this process into a single day by utilizing low doses of oral naltrexone and adjunctive medications to manage withdrawal symptoms.
The results from the study encompassed a total of 415 participants with OUD and unveiled promising findings. The RP demonstrated noninferiority to the SP with a higher rate of successful XR-naltrexone initiation (62.7% vs. 35.8%, respectively). Also, withdrawal severity did not significantly differ between the two procedures.
The implications of these findings suggest that the RP could significantly enhance access to XR-naltrexone treatment by streamlining the initiation process and could potentially revolutionize OUD management. Despite requiring more intensive medical supervision and safety monitoring, the RP offers a time-saving alternative that could make XR-naltrexone a more feasible option for patients with OUD.
The study emphasized the importance of these results which suggest that rapid initiation holds great promise in overcoming barriers to XR-naltrexone adoption. This can aid in improving the patient outcomes and ultimately manage the opioid crisis more effectively by simplifying the treatment process. The key findings of this study marks a major leap ahead in the quest for innovative solutions to address OUD. Overall, the adoption of rapid initiation procedures could represent a crucial point in offering renewed optimism in the battle against OUD.
Reference:
Shulman, M., Greiner, M. G., Tafessu, H. M., Opara, O., Ohrtman, K., Potter, K., Hefner, K., Jelstrom, E., Rosenthal, R. N., Wenzel, K., Fishman, M., Rotrosen, J., Ghitza, U. E., Nunes, E. V., & Bisaga, A. (2024). Rapid Initiation of Injection Naltrexone for Opioid Use Disorder. In JAMA Network Open (Vol. 7, Issue 5, p. e249744). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.9744
Neuroscience Masters graduate
Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751