Extended-release medication offers significant promise for treating alcohol, opioid dependence

A comparatively new form of a medication for alcohol and opioid dependence that’s injected once a month instead of taken orally once a day appears to be significantly more effective than some other medications - because more patients actually continue the prescribed regimen.

The findings, published in the Journal of Substance Abuse Treatment by researchers from Oregon State University and other institutions, offer support for a wider use of medications that may help reduce or prevent substance abuse and related hospital admissions.

The cost savings could offset the cost of the medication, researchers said.

In the past, there has been fairly low use of medications to treat alcohol and opioid dependence. Several treatment options are available, with differing mechanisms of action, and they generally work to reduce the pleasurable feelings associated with drug and alcohol use, thereby discouraging the use of them.

The medication in the study that was found to be more effective than some past approaches was extended-release Naltrexone, which is administered once a month by injection in a medical setting. The research was supported by Alkermes, Inc., the manufacturer of that medication.

“Some of these medications are opioid antagonists, which reduce the euphoric effects of alcohol and some drugs,” said Dan Hartung, an associate professor in the Oregon State University/Oregon Health & Science University College of Pharmacy, and lead author on the study.

“Historically, oral medications for substance abuse have not often been prescribed or found to have a high degree of success, mostly because patients stopped taking them,” Hartung said. “But there are patients who are committed to treating their problems and data showed that they clearly appear to have success with extended-release Naltrexone, which is administered just once a month.”

The issue may be of increased importance, experts said, because of health and prescription drug coverage that is now being made available through the Affordable Care Act. It may make such medications available to many people who previously did not have access to them, and in the process achieve some goals of reducing hospital admissions.

The new meta-analysis combined findings from five other papers, comprising a total of 1,565 patients who received extended-release Naltrexone compared to other therapies for six months, among nearly 60,000 overall patients - the only comprehensive analysis of its type that has been completed.

It found that even though extended-release Naltrexone is expensive - about $1,100 a month - the total health care utilization and costs were generally lower for patients taking it, compared to those using other alcohol-dependence treatments.

They found that significant savings were produced by fewer days of detoxification facility use and inpatient utilization.