{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:08:45Z","timestamp":1790197725472,"version":"4.1.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid dependency is a chronic relapsing disorder for which different therapeutically interventions have been developed. Naltrexone is a non-selective opioid antagonist that can be utilized for maintenance therapy in opioid dependency. In this systematic review, we aimed to evaluate the effects of naltrexone on retention in treatment and being opioid-free.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed and EMBASE databases up to February 5, 2022, using the following keywords: \u201cNaltrexone,\u201d \u201cSubstance abuse,\u201d \u201cDrug abuse,\u201d \u201cOpiate-related disorder,\u201d and \u201cOpioid dependence.\u201d Studies that included opiate-dependent individuals who were treated with naltrexone and assessed retention in treatment or being opioid-free were included. Two authors independently used the Cochrane risk-of-bias tool for quality assessment. A random effect model in Comprehensive Meta-Analysis software was used for the conduction of the meta-analysis. We performed subgroup analysis to evaluate the effects of naltrexone types on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen studies, including 2,280 participants met our inclusion criteria. The duration of treatment ranged from 21 days to 24 months. The retention in treatment with naltrexone was 63% higher than controls (odds ratio (OR): 1.64 [95% confidence interval (CI), 0.78\u20133.44]. The OR for being opioid-free was 1.63 (95% CI, 0.57\u20134.72). Injectable naltrexone was significantly effective on retention in treatment (OR 1.86; 95% CI, 1.17\u20132.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that naltrexone could be useful for retention in treatment and being opioid-free, however, the findings were not significant. Further high-quality and large-scale observational studies are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2022.1003257","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T02:16:45Z","timestamp":1664158605000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["The effects of naltrexone on retention in treatment and being opioid-free in opioid-dependent people: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Moein","family":"Zangiabadian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeid","family":"Golmohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Aria","family":"Nejadghaderi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Mahdi","family":"Zahmatkesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Javad","family":"Nasiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Sadeghian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"B1","unstructured":"2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1596\/32157","article-title":"A review on opioid dependence, mechanism and treatments used: option of treatments: modern versus alternative medicine","volume":"18","author":"Ahmad","year":"2019","journal-title":"Bangladesh J Med Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s41572-019-0137-5","article-title":"Opioid use disorder","volume":"6","author":"Strang","year":"2020","journal-title":"Nat Rev Dis Prim."},{"key":"B4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1093\/epirev\/mxaa006","article-title":"Drug use disorders and violence: associations with individual drug categories","volume":"42","author":"Zhong","year":"2020","journal-title":"Epidemiol Rev."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1001\/archinternmed.2012.3212","article-title":"Opioid dependence vs addiction: a distinction without a difference?","volume":"172","author":"Ballantyne","year":"2012","journal-title":"Arch Intern Med."},{"key":"B6","first-page":"2009","article-title":"Opioid dependence","author":"O'Shea","year":"2009","journal-title":"BMJ Clin Evid"},{"key":"B7","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/GRF.0000000000000422","article-title":"Treating opioid dependence: pain medicine physiology of tolerance and addiction","volume":"62","author":"James","year":"2019","journal-title":"Clin Obstet Gynecol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1001\/jama.294.8.903","article-title":"Anesthesia-assisted vs buprenorphine- or clonidine-assisted heroin detoxification and naltrexone induction: a randomized trial","volume":"294","author":"Collins","year":"2005","journal-title":"JAMA."},{"key":"B9","doi-asserted-by":"publisher","first-page":"225","DOI":"10.36076\/ppj.2008\/11\/225","article-title":"Opioid antagonists, partial agonists, and agonists\/antagonists: the role of office-based detoxification","volume":"11","author":"Helm","year":"2008","journal-title":"Pain Physician."},{"key":"B10","doi-asserted-by":"publisher","first-page":"Cd006140","DOI":"10.1002\/14651858.CD006140.pub2","article-title":"Sustained-release naltrexone for opioid dependence","volume":"2008","author":"Lobmaier","year":"2008","journal-title":"Cochrane Database Of SystRev"},{"key":"B11","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/0740-5472(85)90036-4","article-title":"Naltrexone","volume":"2","author":"Kleber","year":"1985","journal-title":"J Subst Abuse Treat."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1111\/add.14180","article-title":"Extended-release injectable naltrexone for opioid use disorder: a systematic review","volume":"113","author":"Jarvis","year":"2018","journal-title":"Addiction."},{"key":"B13","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"B14","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.2307\/2533446","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"1994","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"B17","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1001\/archpsyc.63.2.210","article-title":"Injectable, sustained-release naltrexone for the treatment of opioid dependence: a randomized, placebo-controlled trial","volume":"63","author":"Comer","year":"2006","journal-title":"Arch Gen Psychiatry."},{"key":"B18","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/S0740-5472(97)00020-2","article-title":"Naltrexone pharmacotherapy for opioid dependent federal probationers","volume":"14","author":"Cornish","year":"1997","journal-title":"J Subst Abuse Treat."},{"key":"B19","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1111\/j.1521-0391.2010.00070.x","article-title":"randomized trial of oral naltrexone for treating opioid-dependent offenders","volume":"19","author":"Coviello","year":"2010","journal-title":"Am J Addict."},{"key":"B20","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.biopsycho.2005.06.005","article-title":"A new approach to preventing relapse in opiate addicts: a psychometric evaluation","volume":"71","author":"Gr\u00fcsser","year":"2006","journal-title":"Biol Psychol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1506","DOI":"10.1016\/S0140-6736(11)60358-9","article-title":"Injectable extended-release naltrexone for opioid dependence: a double-blind, placebo-controlled, multicentre randomised trial","volume":"377","author":"Krupitsky","year":"2011","journal-title":"Lancet."},{"key":"B22","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1001\/archgenpsychiatry.2012.1a","article-title":"Randomized trial of long-acting sustained-release naltrexone implant vs oral naltrexone or placebo for preventing relapse to opioid dependence","volume":"69","author":"Krupitsky","year":"2012","journal-title":"Arch Gen Psychiatry."},{"key":"B23","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1192\/bjp.bp.108.055319","article-title":"Naltrexone implants after in-patient treatment for opioid dependence: randomised controlled trial","volume":"194","author":"Kun\u00f8e","year":"2009","journal-title":"Br J Psychiatry."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1056\/NEJMoa1505409","article-title":"Extended-release naltrexone to prevent opioid relapse in criminal justice offenders","volume":"374","author":"Lee","year":"2016","journal-title":"N Engl J Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1111\/add.12894","article-title":"Opioid treatment at release from jail using extended-release naltrexone: a pilot proof-of-concept randomized effectiveness trial","volume":"110","author":"Lee","year":"2015","journal-title":"Addiction."},{"key":"B26","first-page":"36","article-title":"naltrexone double blind placebo controlled study in Israel","volume":"29","author":"Lerner","year":"1992","journal-title":"Isr J Psychiatry Relat Sci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/jcp.0b013e31814e5e9d","article-title":"Effectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence","volume":"27","author":"Mannelli","year":"2007","journal-title":"J Clin Psychopharmacol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1111\/add.14735","article-title":"Opioid use and dropout from extended-release naltrexone in a controlled trial: implications for mechanism","volume":"115","author":"Nunes","year":"2020","journal-title":"Addiction."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e50673","DOI":"10.1371\/journal.pone.0050673","article-title":"Cost-effectiveness of buprenorphine and naltrexone treatments for heroin dependence in Malaysia","volume":"7","author":"Ruger","year":"2012","journal-title":"PLoS ONE."},{"key":"B30","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1111\/j.1360-0443.1991.tb01859.x","article-title":"Follow-up after a six-month maintenance period on naltrexone versus placebo in heroin addicts","volume":"86","author":"San","year":"1991","journal-title":"Br J Addict."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2192","DOI":"10.1016\/S0140-6736(08)60954-X","article-title":"Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial","volume":"371","author":"Schottenfeld","year":"2008","journal-title":"Lancet."},{"key":"B32","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/0006-3223(94)91240-8","article-title":"The efficacy of naltrexone in preventing reabuse of heroin after detoxification","volume":"35","author":"Shufman","year":"1994","journal-title":"Biol Psychiatry."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2717","DOI":"10.1016\/j.lfs.2005.05.036","article-title":"Naltrexone plus benzodiazepine aids abstinence in opioid-dependent patients","volume":"77","author":"Stella","year":"2005","journal-title":"Life Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.drugalcdep.2013.05.030","article-title":"Naltrexone treatment for opioid dependence: does its effectiveness depend on testing the blockade?","volume":"133","author":"Sullivan","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1046\/j.1360-0443.2002.00217.x","article-title":"systematic review on the efficacy of naltrexone maintenance treatment in opioid dependence","volume":"97","author":"Kirchmayer","year":"2002","journal-title":"Addiction."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e0266142","DOI":"10.1371\/journal.pone.0266142","article-title":"Relative effectiveness of medications for opioid-related disorders: a systematic review and network meta-analysis of randomized controlled trials","volume":"17","author":"Lim","year":"2022","journal-title":"PLoS ONE."},{"key":"B37","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1080\/10550887.2016.1100960","article-title":"Retention in medication-assisted treatment for opiate dependence: a systematic review","volume":"35","author":"Timko","year":"2016","journal-title":"J Addict Dis."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1111\/add.14946","article-title":"Acceptability and efficacy of naltrexone for criminal justice-involved individuals with opioid use disorder: a systematic review and meta-analysis","volume":"115","author":"Bahji","year":"2020","journal-title":"Addiction."},{"key":"B39","doi-asserted-by":"publisher","first-page":"e004393","DOI":"10.1136\/bmjopen-2013-004393","article-title":"Systematic review and meta-analysis of opioid antagonists for smoking cessation","volume":"4","author":"David","year":"2014","journal-title":"BMJ Open."},{"key":"B40","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1080\/0959523021000023180","article-title":"Characteristics, retention and readmissions of opioid-dependent clients treated with oral naltrexone","volume":"21","author":"Bartu","year":"2002","journal-title":"Drug Alcohol Rev."},{"key":"B41","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s13722-015-0034-5","article-title":"Factors associated with willingness to take extended release naltrexone among injection drug users","volume":"10","author":"Ahamad","year":"2015","journal-title":"Addict Sci Clin Pract."},{"key":"B42","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/dar.12095","article-title":"systematic review and meta-analysis of naltrexone implants for the treatment of opioid dependence","volume":"33","author":"Larney","year":"2014","journal-title":"Drug Alcohol Rev."},{"key":"B43","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.biopsych.2010.04.003","article-title":"Risk factors for craving and relapse in heroin users treated with oral or implant naltrexone","volume":"68","author":"Hulse","year":"2010","journal-title":"Biol Psychiatry."},{"key":"B44","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1176\/appi.ajp.2018.17070732","article-title":"A randomized trial comparing extended-release injectable suspension and oral naltrexone, both combined with behavioral therapy, for the treatment of opioid use disorder","volume":"176","author":"Sullivan","year":"2018","journal-title":"Am J Psychiatry."},{"key":"B45","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1111\/add.15572","article-title":"Effect of extended-release naltrexone on alcohol consumption: a systematic review and meta-analysis","volume":"117","author":"Murphy Iv","year":"2022","journal-title":"Addiction."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.1003257\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T02:16:50Z","timestamp":1664158610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.1003257\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,26]]},"references-count":45,"alternative-id":["10.3389\/fpsyt.2022.1003257"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.1003257","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,26]]},"article-number":"1003257"}}