Comparison of Naltrexone Implant and Oral Buprenorphine Naloxone in The Treatment of Opioid Use Disorder: A Retrospective Cohort Study.

Abstract

Introduction: The aim of this study is to compare the duration of abstinence and relapse risk of patients using oral buprenorphine-naloxone (BN-NX) and naltrexone implants (XR-NTX) in the maintenance treatment of opioid use disorder (OUD), and to examine the relationship between relapse risk and some sociodemographic and clinical features.

Methods: Medical records, sociodemographic and clinical characteristics of 284 patients treated for OUD between 2021 and 2023 were retrospectively evaluated in terms of relapse risk and abstinence duration with BUP-NX (107 patients) or XR-NTX (177 patients) as maintenance therapy.

Results: Post-treatment abstinence duration was significantly lower in the BN-NX group than in the XR-NTX group. (p=0.01). There was a statistically significant difference between the groups (BN-NX: 5.6 months, XR-NTX: 6.6 months) in terms of relapse times within 1 year (p=0.026). According to Cox regression analysis, it was concluded that the increase in the age of onset of drug use, the increase in the longest period of abstinence and the use of XR-NTX treatment reduced the risk of relapse, while the increase in the number of inpatient treatments, probation and multiple substance use increased the risk of relapse.

Conclusion: The findings of our study show that XR-NTX may be more effective than BN-NX in preventing relapse in OUD. In addition, it was concluded that probation, age of onset of substance use, multiple substance use, number of inpatient treatments and longest period of abstinence were predictive factors in terms of relapse.