Many in the addiction treatment community already know how hard it is for patients to start a naltrexone regimen. This reality has been codified in a recent first-of-its-kind study published in the Lancet. The study looked at 570 patients with opioid addiction at eight inpatient treatment centers across the country for 24 weeks. Half of the group was assigned to naltrexone and the other half to buprenorphine. Nearly a third of all participants slated for naltrexone treatment dropped out before therapy started compared to just six percent of those who were scheduled to start buprenorphine treatment. The study highlights a disparity in access that recovering addicts experience on a daily basis and can have very real implications for medication-assisted opioid treatment.
The primary reason why many patients find it so hard to access naltrexone, commonly known as Vivitrol is the requirement that they first must undergo detox or abstain from using opioids for several days before starting the drug. Buprenorphine (Suboxone) allows patients to start medication-assisted opioid treatment right after their last cycle of use. The potential for diversion and abuse; however, is arguably much higher for buprenorphine drugs than it is for the once-per-month, slow-acting Vivitrol injection. Patients who ended up going on both drugs had basically equal success, which is an encouraging sign for both types of treatment medications.
Stakeholders all across the addiction treatment conversation agree that, when applicable, medication-assisted opioid treatment combined with rehab and behavior modification are the best formula for treating the disease. It’s important to know which medications are the safest and easiest to access. While access continues to be a problem for naltrexone users, it may be a prime alternative to the documented rates of Suboxone abuse that we’ve seen since the drug was introduced to the clinical landscape in 2002.