Gender differences in treatment and clinical characteristics among patients receiving extended release naltrexone

J Addict Dis. 2016 Oct-Dec;35(4):305-314. doi: 10.1080/10550887.2016.1189659. Epub 2016 May 18.

Abstract

Further research is needed to investigate real-world acceptability of extended-release naltrexone for alcohol and opioid use disorders, and potential gender differences. This study examines treatment and clinical characteristics among men and women receiving extended-release naltrexone in a large, publicly funded substance use disorder treatment system (N = 465; 52% female). Patient demographics, treatment characteristics, and the number of extended-release naltrexone doses received were collected from administrative data and treatment program staff. Additionally, patients provided information on experiences with extended-release naltrexone in an open-ended format at 1, 2, and 3 weeks following their first injection. For a subsample of patients (N = 220), alcohol/opioid cravings and specific adverse effects were also assessed. Compared to men, women reported experiencing a higher rate and mean number of adverse effects. Overall, craving scores showed substantial reductions over time. However, among patients taking extended-release naltrexone for alcohol use, women showed a significantly greater reduction in craving scores compared to men. No gender differences were observed in the number of extended-release naltrexone doses received. Although women may have a greater need for additional support in managing early adverse effects, extended-release naltrexone as an adjunct to psychosocial treatment may be an acceptable and promising treatment approach for both men and women, and particularly for women prescribed extended-release naltrexone for alcohol use. This study contributes further information on patients' experiences during the early course of extended-release naltrexone treatment in real-world settings. Understanding these experiences may assist policy makers and treatment providers in addressing challenges of implementing this treatment into wider practice.

Keywords: Gender differences; alcohol; naltrexone; opioid; substance use disorder treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Delayed-Action Preparations
  • Female
  • Humans
  • Male
  • Naltrexone / administration & dosage
  • Naltrexone / adverse effects
  • Naltrexone / therapeutic use*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / adverse effects
  • Narcotic Antagonists / therapeutic use*
  • Opiate Substitution Treatment / statistics & numerical data*
  • Opioid-Related Disorders / drug therapy
  • Sex Factors
  • Treatment Outcome

Substances

  • Delayed-Action Preparations
  • Narcotic Antagonists
  • Naltrexone