{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:23:44Z","timestamp":1786926224812,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T00:00:00Z","timestamp":1386028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Aims<\/jats:title><jats:p>Naltrexone implants are used to treat opioid dependence, but their safety and efficacy remain poorly understood. We systematically reviewed the literature to assess the safety and efficacy of naltrexone implants for treating opioid dependence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Studies were eligible if they compared naltrexone implants with another intervention or placebo. Examined outcomes were induction to treatment, retention in treatment, opioid and non\u2010opioid use, adverse events, non\u2010fatal overdose and mortality. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Data from randomised studies were combined using meta\u2010analysis. Data from non\u2010randomised studies were presented narratively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five randomised trials (<jats:italic>n<\/jats:italic>\u2009<jats:italic>=<\/jats:italic>\u2009576) and four non\u2010randomised studies (<jats:italic>n<\/jats:italic>\u2009<jats:italic>=<\/jats:italic>\u20098358) were eligible for review. The quality of the evidence ranged from moderate to very low. <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>altrexone implants were superior to placebo implants [risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>): 0.57; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.48, 0.68; <jats:italic>k<\/jats:italic>\u2009<jats:italic>=<\/jats:italic>\u20092] and oral naltrexone (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.57; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.47, 0.70; <jats:italic>k<\/jats:italic>\u2009<jats:italic>=<\/jats:italic>\u20092) in suppressing opioid use. No difference in opioid use was observed between naltrexone implants and methadone maintenance (standardised mean difference: \u22120.33; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22120.93, 0.26; <jats:italic>k<\/jats:italic>\u2009<jats:italic>=<\/jats:italic>\u20091); however, this finding was based on low\u2010quality evidence from one study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The evidence on safety and efficacy of naltrexone implants is limited in quantity and quality, and the evidence has little clinical utility in settings where effective treatments for opioid dependence are used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Better designed research is needed to establish the safety and efficacy of naltrexone implants. Until such time, their use should be limited to clinical trials. <jats:italic>[Larney S, Gowing L, Mattick RP, Farrell M, Hall W, Degenhardt L. A systematic review and meta\u2010analysis of naltrexone implants for the treatment of opioid dependence. <\/jats:italic>Drug Alcohol Rev<jats:italic> 2014;33:115\u2013128]<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.12095","type":"journal-article","created":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T06:33:19Z","timestamp":1386052399000},"page":"115-128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["A systematic review and meta\u2010analysis of naltrexone implants for the treatment of opioid dependence"],"prefix":"10.1111","volume":"33","author":[{"given":"Sarah","family":"Larney","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"},{"name":"Alpert Medical School Brown University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Gowing","sequence":"additional","affiliation":[{"name":"School of Medical Sciences University of Adelaide  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Mattick","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Hall","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"},{"name":"School of Population and Global Health University of Melbourne  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001333.pub3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-010-0135-5"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006140.pub2"},{"key":"e_1_2_8_5_1","volume-title":"Naltrexone implant treatment for opioid dependence","author":"NHMRC: National Health and Medical Research Council","year":"2010"},{"key":"e_1_2_8_6_1","first-page":"115","article-title":"Epidemiologic and molecular pathophysiology of chronic opioid dependence and the place of naltrexone extended\u2010release formulations in its clinical management","volume":"6","author":"Reece AS","year":"2012","journal-title":"Subst Abuse"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.03910.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_9_1","unstructured":"HigginsJPT GreenS eds.2011.Cochrane handbook for systematic review of interventions version 5.1.0. 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