Impact of Impulsivity, Hyperactivity, and Inattention on Discontinuation Rate among Opioid-Dependent Patients Treated with Extended-Release Naltrexone

Int J Environ Res Public Health. 2022 Sep 11;19(18):11435. doi: 10.3390/ijerph191811435.

Abstract

Previous studies have indicated elevated levels of impulsivity, hyperactivity, and inattention (IHI) among opioid-dependent patients seeking outpatient treatment with extended-release naltrexone (XR-NTX). This led us to hypothesize that IHI may be associated with a higher discontinuation rate for XR-NTX treatment. In a group of 162 patients with opioid dependence, discontinuation prior to the full 24 weeks of the study period (six injections and attending the study visit at 24 weeks) occurred in 49% of the patients, primarily in the early stage of treatment. IHI above the clinical cut-off on the adult ADHD self-report scale (ASRS) was not associated with a risk of premature discontinuation. This finding was not altered when controlling for socio-demographics, substance, use and mental health severity. Conclusively, high levels of IHI per se is not contradictive for XR-NTX treatment in regard to concern for premature discontinuation.

Keywords: extended-release naltrexone; impulsivity; retention in treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Delayed-Action Preparations / therapeutic use
  • Humans
  • Impulsive Behavior
  • Injections, Intramuscular
  • Naltrexone* / adverse effects
  • Naltrexone* / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Opioid-Related Disorders* / drug therapy

Substances

  • Analgesics, Opioid
  • Delayed-Action Preparations
  • Narcotic Antagonists
  • Naltrexone

Grants and funding

An unrestricted grant was provided by the Research Council of Norway (grant 269864) along with the South-Eastern Norway Regional Health Authority (2019105).