Preliminary evaluation of extended-release naltrexone in Michigan and Missouri drug courts

• Published in: Journal of substance abuse treatment Vol. 41; no. 3; pp. 288 - 293
• Main Authors: Finigan, Michael W., Ph.D, Perkins, Tamara, Ph.D, Zold-Kilbourn, Phyllis, Ph.D, Parks, Joseph, M.D, Stringer, Mark, M.A
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2011; Elsevier; Elsevier Limited
• Subjects: Addictions; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol dependence; Alcohol Drinking - legislation & jurisprudence; Alcohol Drinking - prevention & control; Alcoholism - drug therapy; Automobile Driving - legislation & jurisprudence; Biological and medical sciences; Courts; Criminal justice; Criminal Law; Delayed-Action Preparations - administration & dosage; Delayed-Action Preparations - therapeutic use; Desintoxication. Drug withdrawal; Drug addiction; Drug courts; Federal courts; Female; Humans; Indexing in process; Injections, Intramuscular; Law enforcement; Male; Medical sciences; Michigan; Miscellaneous; Missouri; Naltrexone; Naltrexone - administration & dosage; Naltrexone - therapeutic use; Narcotic Antagonists - administration & dosage; Narcotic Antagonists - therapeutic use; Pilot Projects; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recruitment; Relative risks; Retrospective Studies; Substance abuse; Substance Abuse Detection; Substance abuse treatment; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - prevention & control; Temperance; Treatments; Vivitrol; United States; North America; America; Missouri; Michigan; United States > US; Alcohol dependence; Law enforcement; Naltrexone; Vivitrol; Criminal justice; Morphinan derivatives; Human; Justice; Drug; Evaluation; Drug addiction; Replacement therapy; Poison withdrawal; Controlled release form; Alcoholism; Criminality; Legislation; Forensic aspect; Alcoholic beverage; Dependence; Legal aspect; Public health
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2011.04.003

Abstract This pilot study, a retrospective case series analysis, examined the feasibility and effectiveness of treating alcohol dependence with extended-release naltrexone (XR-NTX) in the drug court setting. In two Michigan courts and in one Missouri court, 32 clients were treated with XR-NTX and were matched with 32 clients with standard care in an open-label, voluntary recruitment design. Treatment with XR-NTX was associated with relative risk reductions (RRRs; p = ns ) of 57% fewer missed drug court sessions, a 35% reduction in the monthly ratio of positive drug and alcohol tests to total tests, and 35% fewer individuals with greater than 25% overall positive alcohol or drug tests. In the principal end-point analysis of annualized number of new arrests, 26% of standard-care clients were rearrested versus 8% on XR-NTX (RRR = 69%; p < .05). Treatment with XR-NTX appeared to be feasible and was associated with a consistently large treatment effect across multiple outcomes relevant to the drug court setting.