title: Extended-release naltrexone for treatment of alcohol dependence in primary care.
abstract: The feasibility of using extended-release injectable naltrexone (XR-NTX) to treat alcohol dependence in routine primary care settings is unknown. An open-label, observational cohort study evaluated 3-month treatment retention, patient satisfaction, and alcohol use among alcohol-dependent patients in two urban public hospital medical clinics. Adults seeking treatment were offered monthly medical management (MM) and three XR-NTX injections (380 mg, intramuscular). Physician-delivered MM emphasized alcohol abstinence, medication effects, and accessing mutual help and counseling resources. Seventy-two alcohol-dependent patients were enrolled; 90% (65 of 72) of eligible subjects received the first XR-NTX injection; 75% (49 of 65) initiating treatment received the second XR-NTX injection; 62% (40 of 65), the third. Among the 56% (n = 40) receiving three injections, median drinks per day decreased from 4.1 (95% confidence interval = 2.9-6) at baseline to 0.5 (0-1.7) during Month 3. Extended-release naltrexone delivered in a primary care MM model appears a feasible and acceptable treatment for alcohol dependence.
authors.affiliation: New York University School of Medicine, New York, NY 10010, USA. joshua.lee@med.nyu.edu
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Lee
authors.forename: Ellie
authors.initials: E
authors.lastname: Grossman
authors.forename: Danae
authors.initials: D
authors.lastname: DiRocco
authors.forename: Andrea
authors.initials: A
authors.lastname: Truncali
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hanley
authors.forename: David
authors.initials: D
authors.lastname: Stevens
authors.forename: John
authors.initials: J
authors.lastname: Rotrosen
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000534:rehabilitation*; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone