• Kristin Klemmetsby Solli, Zill-E-Huma Latif, Arild Opheim, Peter Krajci, Kamni Sharma-Haase, Jūratė Šaltytė Benth, Lars Tanum, and Nikolaj Kunoe.
• Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
• Addiction. 2018 Oct 1; 113 (10): 1840-1849.

Background And AimThis is a follow-up study of a previously published randomized clinical trial conducted in Norway that compared extended-release naltrexone (XR-NTX) to buprenorphine-naloxone (BP-NLX) over 3 months. At the conclusion of the trial, participants were offered their choice of study medication for an additional 9 months. While BP-NLX was available at no cost through opioid maintenance treatment programmes, XR-NTX was available only through study participation, accounting for why almost all participants chose XR-NTX in the follow-up. The aim of this follow-up study was to compare differences in outcome between adults with opioid dependence continuing XR-NTX and those inducted on XR-NTX for a 9-month period, on measures of effectiveness, safety and feasibility.DesignIn this prospective cohort study, participants were either continuing XR-NTX, changed from BP-NLX to XR-NTX or re-included into the study and inducted on XR-NTX treatment.SettingFive urban, out-patient addiction clinics in Norway.ParticipantsOpioid-dependent adults continuing (n = 54) or inducted on (n = 63) XR-NTX.InterventionXR-NTX administrated as intramuscular injections (380 mg) every fourth week.MeasurementsData on retention, use of heroin and other illicit substances, opioid craving, treatment satisfaction, addiction-related problems and adverse events were reported every fourth week.FindingsNine-month follow-up completion rates were 51.9% among participants continuing XR-NTX in the follow-up and 47.6% among those inducted on XR-NTX. Opioid abstinence rates were, respectively, 53.7 and 44.4%. No significant group differences were found in use of heroin and other opioids.ConclusionsOpioid-dependent individuals who elect to switch from buprenorphine-naltrexone treatment after 3 months to extended-release naltrexone treatment for 9 months appear to experience similar treatment completion and abstinence rates and similar adverse event profiles to individuals who had been on extended-release naltrexone from the start of treatment.© 2018 Society for the Study of Addiction.

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