Effectiveness of extended release naltrexone to reduce alcohol cravings and use behaviors during treatment and at follow-up.

Changes in cravings to drink alcohol and alcohol use behaviors were examined among 337 patients who were administered extended-release naltrexone (XR-NTX) in conjunction with psychosocial treatment in community-based substance use disorder treatment programs. Cravings and use behaviors were assessed at multiple time points (baseline; weeks 1, 2, and 3 after the first dose; monthly after the first four assessments; and at 30- and 60-days after the last dose). A total of 863 doses (M=2.6, SD=1.8) were administered and the majority of patients (65%) took more than one dose. Alcohol craving scores decreased from 19 to 5.7 after the first dose of XR-NTX. Days of primary alcohol use at admission (M=10.5, SD=10.1) were reduced at discharge (M=to 1.2, SD=4.6). At the first follow-up, 79.8% reported no alcohol use and 77.8% reported no alcohol use at the second follow-up. The expected side effects were reported but the medication was well tolerated and there was no relationship between side effects and subsequent dose. Unexamined or unaccounted for variables (e.g., motivation, external pressures to remain in treatment) are "real world" consequences that may have impacted the outcome of this study. Results indicated that use of the antagonist medication XR-NTX may be related to significant decreases in alcohol craving and use while a patient is in treatment, as well as at 30- and 60-days after the final dose.