Naltrexone cuts relapse rate and overdose among opioid-dependent offenders

After leaving prison, patients who receive naltrexone are less likely to relapse and overdose than those who receive standard treatment, study finds.

Prison cells

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
(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.


[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

Last updated
Clinical Pharmacist, CP, May 2016, Vol 8, No 5;8(5):DOI:10.1211/PJ.2016.20201002

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