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Criminal offenders are disproportionately affected by opioid dependence. But opioid replacement therapies, such as methadone, carry risks of abuse and overdose, and patients frequently relapse after leaving prison.
In a study published in The
New England Journal of Medicine
[1]
(online, 31 March 2016), US researchers randomly assigned 308 previously incarcerated offenders to usual treatment (brief counselling and referral to community treatment programmes) or a 24-week course of extended-release naltrexone, an opioid blocker.
The median time to relapse was significantly increased in the naltrexone group, at 10.5 weeks compared with 5.0 weeks in the usual-treatment group. Of the naltrexone-treated patients, 43% relapsed, compared with 64% in the other group. And, one year later, no patients who received naltrexone overdosed, versus seven in the control group.
The researchers say long-term studies are needed to establish if these benefits can be sustained.
References
[1] Lee JD, Friedmann PD, Kinlock TW et al. Extended-release naltrexone to prevent opioid relapse in criminal justice offenders. New England Journal of Medicine 2016;374:1232–1242. doi: 10.1056/NEJMoa1505409
