20 May Extended-Release Naltrexone Offers Promise for Alcoholics, Opioid Addicts
Treating opiate and alcohol addiction could prove more effective and less costly with the use of time-release, injected naltrexone, a University of Oregon study has concluded.
Why? Because users were more likely to comply with the medication on a once-monthly cycle of injections than they were to take a pill every day, the authors reported.
“Some of these medications are opioid antagonists, which reduce the euphoric effects of alcohol and some drugs,” Dan Hartung, an associate professor in the Oregon State University/Oregon Health & Science University College of Pharmacy, and lead author on the study, said in a news announcement.
“Historically, oral medications for substance abuse have not often been prescribed or found to have a high degree of success, mostly because patients stopped taking them,” Hartung said. “But there are patients who are committed to treating their problems and data showed that they clearly appear to have success with extended-release naltrexone, which is administered just once a month.”
Faced with a nation of skyrocketing prescription pill dependence, primarily opiates, and government studies that show less than one-third of alcoholics get treatment at all, the value is obvious in seeking an ever-better understanding of drugs that work and why.
Dr. Ash Bhatt, medical director of The Recovery Place and chief medical officer for Elements Behavioral Health’s Florida region, called the abysmally low use of naltrexone in any form “a true injustice.”
“Alcoholism is a worldwide epidemic that crosses all socioeconomic classes and causes significant morbidity and mortality,” Dr. Bhatt said. “Underutilization of medications available to treat alcoholism, especially in the United States, is a tremendous irony.”
The increase in mental health and prescription drug coverage that is now being provided by the Affordable Care Act was partly why the Oregon State University researchers said they examined extended-release naltrexone. The new healthcare law may make such medications available to many people who previously did not have access to them.
A study also published last week by researchers at the University of North Carolina at Chapel Hill looked at why two oral medicines approved by the FDA in the 1990s for alcoholism — naltrexone and acamprosate — are seldom used. Those researchers analyzed drug trials spanning two decades and 23,000 subjects to conclude that a lack of knowledge about the newer and effective drugs on the part of doctors and horror stories surrounding drugs such as Antabuse that made people miserably ill when they consumed alcohol, prevent most doctors and patients from considering them.
In the study of the time-release form of naltrexone, published this month in the Journal of Substance Abuse Treatment, researchers found patients were more successful at staying sober with an injection in a medical setting. The results encourage more broad use of the medication to prevent or treat substance addiction at an ultimately lower cost. The savings in the long run, including fewer days of detoxification and inpatient treatment, could offset the immediate cost of the medication, which can run $1,100 a month, researchers said.
In fact, opioid-dependent users of the extended-release medicine “had lower inpatient substance abuse-related utilization versus other agents and $8,170 lower total cost versus methadone,” the researchers said.
Alcohol and drug use disorders affect about 8 percent of the nation’s population. But treatment of alcohol dependence with medications ranks the lowest among 25 health and behavior conditions.
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