{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:21:31Z","timestamp":1791390091447,"version":"4.3.3"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>\n                      Extended\u2010release formulations of naltrexone have emerged as effective treatment options for opioid use disorder. This\n                      <jats:italic>post\u2010hoc<\/jats:italic>\n                      analysis examined the temporal relationship between episodes of opioid use and subsequent dropout in a placebo\u2010controlled trial of extended\u2010release injection naltrexone (XR\u2010NTX) to draw inferences about the mechanism by which extended blockade of opioid receptors translates into clinical effectiveness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a 24\u2010week multiple\u2010site, double\u2010blind, randomized trial of monthly XR\u2010NTX versus placebo injections. We analyzed time to dropout from treatment using survival analysis with an extended Cox model as a function of treatment (XR\u2010NTX versus placebo) and with weekly urine drug test (UDT) results for opioids at each week as a time\u2010dependent covariate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Thirteen addiction treatment programs in Russia, 2008\u201309.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 250 adults with opioid use disorder who had completed in\u2010patient detoxification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>XR\u2010NTX injection or placebo injection every 4\u00a0weeks with weekly clinic visits and biweekly counseling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Urine toxicology for opioids measured weekly and week of dropout from treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      The Cox model yielded a significant interaction of time\u2010dependent urine toxicology by treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.024). Among patients receiving placebo, a positive UDT in a given week increased the risk for dropout from treatment in the subsequent week [hazard ratio (HR)\u00a0=\u00a06.25; 95% confidence interval (CI)\u00a0=\u00a03.6\u201310.0], whereas among patients receiving XR\u2010NTX, a positive UDT result showed no significant effect on risk for dropout (HR\u00a0=\u00a01.67; 95% CI\u00a0=\u00a00.6\u20134.5). The proportion of patients who completed all 24\u00a0weeks without any positive UDT result was 31% on XR\u2010NTX compared with 20% on placebo (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.051).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extended\u2010release injection naltrexone was effective at reducing the risk of dropout from opioid use disorder treatment after an episode of opioid use. Just under a third of patients (31%) on XR\u2010NTX had no opioid\u2010positive urine tests across the trial, but the hypothesis that this would differ from placebo (20%) was not confirmed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.14735","type":"journal-article","created":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T04:50:41Z","timestamp":1563339041000},"page":"239-246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Opioid use and dropout from extended\u2010release naltrexone in a controlled trial: implications for mechanism"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-3425","authenticated-orcid":false,"given":"Edward V.","family":"Nunes","sequence":"first","affiliation":[{"name":"New York State Psychiatric Institute Columbia University Medical Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4243-6462","authenticated-orcid":false,"given":"Adam","family":"Bisaga","sequence":"additional","affiliation":[{"name":"New York State Psychiatric Institute Columbia University Medical Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-4525","authenticated-orcid":false,"given":"Evgeny","family":"Krupitsky","sequence":"additional","affiliation":[{"name":"St Petersburg Pavlov State Medical University  St Petersburg Russia"},{"name":"Department of Addictions V.M. 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