title: Baseline characteristics of patients predicting suitability for rapid naltrexone induction.
abstract: OBJECTIVE
  Extended-release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre-treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment.
  
  
  METHODS
  A chart review of 150 consecutive research participants (N = 84 completers and N = 66 non-completers) undergoing a rapid naltrexone induction with the buprenorphone-clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction-detoxification.
  
  
  RESULTS
  Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level.
  
  
  CONCLUSIONS
  Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone.
  
  
  CONCLUSIONS
  Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction.
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, New York, NY.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Mogali
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, New York, NY.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Khan
authors.affiliation: Department of Biostatistics, Columbia University, New York, NY.
authors.forename: Esther S
authors.initials: ES
authors.lastname: Drill
authors.affiliation: Department of Biostatistics, Columbia University, New York, NY.
authors.forename: Martina
authors.initials: M
authors.lastname: Pavlicova
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sullivan
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, New York, NY.|Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY.
authors.forename: Edward
authors.initials: E
authors.lastname: Nunes
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, New York, NY.|Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY.
authors.forename: Adam
authors.initials: A
authors.lastname: Bisaga
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage; D003000:Clonidine / Q000008:administration & dosage; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D018579:Patient Selection; D011379:Prognosis
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D002047:Buprenorphine; D009271:Naltrexone; D003000:Clonidine