Abstract

Objective

Previous research has demonstrated the effectiveness of both extended-release injectable naltrexone (XR-NTX) and buprenorphine/naloxone (BUP-NX) in the treatment of opioid use disorder (OUD). However, studies using real-world samples with multiple medical and psychiatric comorbidities are lacking. The study’s primary aims were to: (1) compare clinical presentations in an inclusive sample of OUD-diagnosed US military veterans receiving XR-NTX and BUP-NX, and (2) investigate differences in 90-day treatment outcomes between these two groups. Methods: The medical records of 79 patients receiving medications to treat OUD in a VA hospital’s addiction outpatient treatment program were reviewed retrospectively. The analysis included all veterans who initiated medication treatment during the study period. Differences between medication groups on co-occurring diagnoses, treatment retention, and related outcomes were examined. Results: The two groups were similar in medical and psychiatric comorbidity, although the BUP-NX group were more likely to have a pain diagnosis. No statistically significant differences in retention or toxicology results were found between the two groups over the 90-day study period. The rate of positive urine screens for the BUP-NX group was 19.2% for opiates and 13.5% for other illicit substances, and 3.7% and 11.1% respectively for the XR- NTX group. Conclusion: There was no evidence that 90-days outcomes differed for veterans based on medication received, and there were more similarities than differences in clinical characteristics. Additional research is needed, including larger sample size and prospective randomized control trial to evaluate VA patients’ treatment outcomes receiving BUP-NX or XR-NTX for OUD.

中文翻译：

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丁丙诺啡纳洛酮和缓释注射纳曲酮用于治疗退伍军人样本中的阿片类药物使用障碍：回顾性图表审查

摘要

客观的

先前的研究已经证明了缓释注射纳曲酮 (XR-NTX) 和丁丙诺啡/纳洛酮 (BUP-NX) 在治疗阿片类药物使用障碍 (OUD) 方面的有效性。然而，缺乏使用具有多种医学和精神疾病的真实样本的研究。该研究的主要目的是：（1）比较接受 XR-NTX 和 BUP-NX 的经 OUD 诊断的美国退伍军人的包容性样本的临床表现，以及（2）调查这两组之间 90 天治疗结果的差异。方法：回顾性审查了在 VA 医院的成瘾门诊治疗计划中接受药物治疗 OUD 的 79 名患者的医疗记录。分析包括在研究期间开始药物治疗的所有退伍军人。检查了药物组之间在同时发生的诊断、治疗保留和相关结果方面的差异。结果：尽管 BUP-NX 组更有可能被诊断为疼痛，但两组在医学和精神共病方面相似。在 90 天的研究期间，两组之间在保留或毒理学结果方面没有发现统计学上的显着差异。BUP-NX 组的尿检阳性率为阿片类药物 19.2% 和其他违禁物质 13.5%，XR-NTX 组分别为 3.7% 和 11.1%。结论：没有证据表明退伍军人的 90 天结局因接受的药物而异，并且临床特征的相似性多于差异。需要更多的研究，包括更大的样本量和前瞻性随机对照试验，以评估接受 BUP-NX 或 XR-NTX 治疗 OUD 的 VA 患者的治疗结果。