Impact of extended release naltrexone on health-related quality of life in individuals with legal involvement and opioid use disorders

Abstract

Background: Understanding the impact of medications for opioid use disorder on health related quality of life (QOL) may help to explain why few individuals with legal involvement remain in treatment, specifically those receiving opioid antagonists. QOL is an established predictor of treatment retention and has been shown to improve with some treatment for opioid use disorder. Yet limited research has examined QOL with opioid antagonists. We examined the impact of extended release naltrexone (XR-NTX) on QOL and retention in treatment in a randomized, multi-site trial of individuals with legal involvement. Methods: The participants were 308 community-dwelling adults with current or recent legal involvement with opioid dependence at five site across United States. They were randomized to receive XR-NTX or treatment as usual for 6 months. QOL was measured every 2 weeks using Euro QOL individual items, summary index score, and health state today metric. Results: No significant difference in QOL scores were observed between the two groups at the completion of active treatment or on follow up at 52 and 78 weeks. There were no time effects of treatment on scores. Contrary to expectation, baseline and average QOL did not predict retention in treatment. Conclusion: In contrast to prior research, our findings did not demonstrate significant changes (improvements or decreases) in QOL associated with XR-NTX treatment. Clinicians may consider that individuals receiving XR-NTX may not experience changes in perceived well-being in response to treatment and consider discussing with patients that they may not necessarily perceive improvement in their QOL. This may help to ground patient’s expectations about the effects of treatment and potentially reduce attrition from treatment with opioid antagonists.

Key Words:

• Opioid use disorder
• medication for opioid use disorder
• quality of life
• extended release naltrexone
• criminal justice
• medication assisted treatment

Acknowledgements

We wish to thank the individuals who participated in this study and their willingness to answer questions about their wellbeing throughout study enrollment. We also want to thank Randall Hoskinson Jr. and Donna Wilson, M.S. for their assistance with data processing and cleaning.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Secondary data analysis of this data was funded by the University of Massachusetts Medical School Life Sciences Moment Fund Award. The original study was funded by the National Institutes of Health R01DA024549.