Injectable extended-release naltrexone (Vivitrol) appears to be as safe and effective as daily oral buprenorphine-naloxone for treating opioid dependence, according to a Norway-based, noninferiority trial in JAMA Psychiatry.
Roughly 160 opioid-dependent adults who were discharged from addiction treatment programs were randomized to receive either oral buprenorphine-naloxone daily or extended-release intramuscular naltrexone every 4 weeks for 12 weeks. Urine drug tests were performed weekly throughout the trial.
The total number of opioid-negative drug tests did not differ significantly between the groups (average, 0.8–0.9 negative tests). Self-reported days of use of heroin and other illicit opioids also did not differ between the groups.
Participants receiving extended-release naltrexone reported less heroin craving and more treatment satisfaction than did buprenorphine-naloxone recipients. Serious adverse events were similar with the two treatments.
The researchers conclude that extended-release naltrexone “should be considered as a treatment option for opioid-dependent individuals.”