title: Long-acting injectable depot naltrexone use in the Veterans' Health Administration: a national study.
abstract: BACKGROUND
  Alcohol use disorders affect millions, but few utilize medications. This paper examines factors contributing to the use of long-acting injectable depot naltrexone (LADN) in a large patient population.
  
  
  METHODS
  Bivariate analysis, stepwise multivariate logistic regression, and multivariate logistic regression analysis were used.
  
  
  RESULTS
  The sample had 101,026 patients of whom 3180 (3.1%) received any form of naltrexone and 240 (0.24%) received LADN. Of those who received naltrexone, only 7.5% (240/3180) received LADN. The LADN group was more likely to have outpatient mental health service use and a mental health inpatient admission. The LADN group was more likely to have a co-morbid Axis 1 psychiatric disorder and to fill a psychotropic prescription.
  
  
  CONCLUSIONS
  In order to better serve and understand the implications of LADN treatment for the patient population that uses and may benefit from it, more research is needed on the effectiveness of this medication in the dually-diagnosed and high service use population.
authors.affiliation: Yale University School of Medicine, West Haven, CT, USA. Electronic address: Carla.marienfeld@yale.edu.
authors.forename: Carla
authors.initials: C
authors.lastname: Marienfeld
authors.forename: Theddeus
authors.initials: T
authors.lastname: Iheanacho
authors.forename: Mohammed
authors.initials: M
authors.lastname: Issa
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
mesh_terms: D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000627:therapeutic use; D017831:Diagnosis, Dual (Psychiatry); D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009271:Naltrexone / Q000008:administration & dosage* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014505:Urban Population / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Alcohol use disorders treatment; Depot; Dual-diagnosis; Health services research; LADN; Long-acting depot naltrexone; Naltrexone; VHA; Veterans' Health Administration