An open label naturalistic study of predictors of retention and compliance to naltrexone maintenance treatment among patients with opioid dependence

Background: This study aimed at assessment of retention and compliance to naltrexone for long-term management among patients with opioid dependence syndrome over a follow-up period of 15 months. Additionally, it aimed to identify predictors of retention in naltrexone treatment.

Methods: The study was conducted at a tertiary care drug dependence treatment centre. The study involved patients with opioid dependence syndrome who were prescribed naltrexone for long-term management. Information was collected for socio-demographic variables, drug use history, diagnosis, retention and compliance to naltrexone treatment. Data were analysed using SPSS ver 21 (IBM Inc., New York, NY).

Results: One hundred fifty-three patients were enrolled in naltrexone maintenance treatment following an initial detoxification phase. Duration of retention was longer among those who did not report concurrent use of cannabis (z?=?2.06, p?=?0.03) or benzodiazepines (z?=?2.04, p?=?0.04) at the time of presentation to treatment centre. Marital status (OR 3.61, 95% CI 0.96–8.22), employment status (OR 8.18, 95% CI 1.68–16.53), age at onset of opioid use (OR 13.17, 95% CI 1.08–1.31), duration of opioid use (OR 11.56, 95% CI 0.97–0.99) and number of abstinence attempts in past (OR 7.49, CI 1.20–3.07) as predictors of retention at 90 days (Table 4). Similarly, marital status (OR 4.80, 95% CI 1.13–10.22), employment status (OR 4.90, 95% CI 1.20–21.61), duration of opioid use (OR 8.11, 95% CI 0.96–0.99) and number of abstinence attempts in past (OR 8.18, 95% CI 1.23–3.05) were predictors of retention at 180 days.

Conclusions: Certain socio-demographic and drug use related variables are predictors of longer retention in naltrexone treatment. These factors can guide the selection process for the patients suited for long-term maintenance with naltrexone for opioid dependence.