• N IrwinMadisonM0000-0003-3769-7035Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.University of Michigan Health Department of Pharmacy, Ann Arbor, Michigan, USA., David A Cooke, Daniel Berland, D MarshallVincentVClinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA., and A SmithMichaelM0000-0002-9762-0104Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.University of Michigan Health Department of Pharmacy, Ann Arbor, Michigan, USA..
• Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
• J Pain Palliat Care Pharmacother. 2024 Mar 1; 38 (1): 131913-19.

AbstractNaltrexone is a mu-opioid receptor antagonist increasingly used as an analgesic for chronic pain at low doses. This retrospective, observational cohort study was conducted at an academic medical center to evaluate low-dose naltrexone (LDN) efficacy and describe its use in routine clinical practice. Adults receiving LDN, doses <10 mg for ≥1 month, seen at an outpatient pain clinic from January 1, 2014 to April 1, 2022 were included. The primary outcome was change in the Pain, Enjoyment of Life, and General Activity (PEG) score after LDN. Thirty-one patients were included. Median age was 50 years and 71% were female. Median duration of pain at baseline was 5 years. Mean PEG scores were 7.27 ± 1.39 and 6.62 ± 2.04 at baseline and follow-up, respectively. Mean difference was 0.66 (95% CI [0.10-1.21], p = 0.022). Eighty-seven percent (27) of patients discontinued LDN, 52% (16) for lack of benefit, 23% (7) for loss of benefit, 10% (3) for side effects, and 3% (1) for other reasons. Seven (23%) reported side effects. LDN was associated with a statistically significant reduction in PEG in adult chronic pain patients, however the clinical significance is unclear as over 75% of patients discontinued LDN due to lack of benefit.

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