Matisyahu Shulman1, Mei Chen Hu, Edward V Nunes, Adam Bisaga. 1. From the Department of Psychiatry, Division on Substance Use Disorders, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY (MS, EVN, AB), Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY (MS, MC, EVN, AB).
Abstract
BACKGROUND AND OBJECTIVE: Many patients are unable to initiate long-acting injectable naltrexone (XR-NTX) on a first attempt, due to the prerequisite abstinence and withdrawal from opioids. METHODS: Thirty patients who were unable to initiate XR-NTX were recruited to receive buprenorphine for 1 week, followed by a 3-week buprenorphine taper, and an ascending titration of oral naltrexone before XR-NTX injection. RESULTS: Eight (27%) initiated XR-NTX, 7 (23%) transitioned to buprenorphine maintenance treatment and 15 (50%) were lost to follow up. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: A second attempt at XR- NTX initiation using buprenorphine stabilization and cross taper may be a reasonable approach for some patients.
BACKGROUND AND OBJECTIVE: Many patients are unable to initiate long-acting injectable naltrexone (XR-NTX) on a first attempt, due to the prerequisite abstinence and withdrawal from opioids. METHODS: Thirty patients who were unable to initiate XR-NTX were recruited to receive buprenorphine for 1 week, followed by a 3-week buprenorphine taper, and an ascending titration of oral naltrexone before XR-NTX injection. RESULTS: Eight (27%) initiated XR-NTX, 7 (23%) transitioned to buprenorphine maintenance treatment and 15 (50%) were lost to follow up. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: A second attempt at XR- NTX initiation using buprenorphine stabilization and cross taper may be a reasonable approach for some patients.
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