---
title: "Psych News Alert: Extended-Release Naltrexone as Effective, Safe as Buprenorphine-Naloxone, Study Finds"
description: Treatment with extended-release naltrexone appears to be as safe and effective as daily oral buprenorphine-naloxone in maintaining short-...
image: https://alert.psychnews.org/hubfs/Imported_Blog_Media/syringe_iStock-507479146-Jun-24-2025-10-34-01-3635-PM.jpg
---

 10/24/17 12:00 AM

# Extended-Release Naltrexone as Effective, Safe as Buprenorphine-Naloxone, Study Finds

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Treatment with extended-release naltrexone appears to be as safe and effective as daily oral buprenorphine-naloxone in maintaining short-term abstinence from heroin and other illicit substances in newly detoxified individuals, according to a [study](https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2657484) in *JAMA Psychiatry*. The findings were based on a 12-week, multicenter, outpatient, open-label trial conducted at five addiction clinics in Norway. 

After detoxification, 159 opioid-dependent adults (according to *DSM-4*) were randomly assigned to either daily oral flexible dose buprenorphine-naloxone (4 mg/d to 24 mg/d) or extended-release naltrexone hydrochloride (380 mg, administered intramuscularly every fourth week) for 12 weeks. At the start of the trial and again at 4, 8, and 12 weeks, patients underwent a structured interview using the European version of the Addiction Severity Index covering drug use, physical and mental health, work, education, and criminal activity. 

Treatment with extended-release naltrexone was found to be as effective as buprenorphine-naloxone at maintaining retention in treatment (mean number of days until dropout from study medication: 69.3 days and 63.7 days of 84 days, respectively). Additionally, there were no significant differences between the treatment groups in the proportion of opioid-negative urine drug tests, or pattern of use of amphetamine, cocaine, alcohol, cannabis, or injecting drugs. 

Participants receiving extended-release naltrexone reported significantly less heroin craving and thoughts about heroin than did buprenorphine-naloxone participants, as well as greater treatment satisfaction. Individuals in the extended-release naltrexone group reported more adverse events than those in the buprenorphine-naloxone group (49 [69.0%] vs 25 [34.7%]). Some of these events were related to induced or experienced withdrawal symptoms, such as nausea, chills, shivering, diarrhea, and sneezing, the authors reported.

“Maintaining short-term opioid abstinence with extended-release naltrexone should be considered an equal treatment alternative to buprenorphine-naloxone as medication-assisted treatment for opioid-dependent individuals,” Lars Tanum, M.D., D.M.Sc., of the University of Oslo in Norway and colleagues wrote.

For related information, see the *Psychiatric News* article “[Low-Dose Naltrexone May Mitigate Severity of Opioid Withdrawal During Detox](http://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.3b10)" and the *Psychiatric Services* article “[Fentanyl and the Evolving Opioid Epidemic: What Strategies Should Policy Makers Consider?](http://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201700235).”

(Image: iStock/Ca-ssis)

[amphetamine](https://alert.psychnews.org/tag/amphetamine), [withdrawal](https://alert.psychnews.org/tag/withdrawal), [Lars Tanum](https://alert.psychnews.org/tag/lars-tanum), [cocaine](https://alert.psychnews.org/tag/cocaine), [alcohol](https://alert.psychnews.org/tag/alcohol), [buprenorphine-naloxone](https://alert.psychnews.org/tag/buprenorphine-naloxone), [extended-release naltrexone](https://alert.psychnews.org/tag/extended-release-naltrexone), [opioid dependence](https://alert.psychnews.org/tag/opioid-dependence), [cannabis](https://alert.psychnews.org/tag/cannabis), [JAMA Psychiatry](https://alert.psychnews.org/tag/jama-psychiatry)

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[opioid use disorder](https://alert.psychnews.org/tag/opioid-use-disorder), [naltrexone](https://alert.psychnews.org/tag/naltrexone), [heroin](https://alert.psychnews.org/tag/heroin), [prescription painkiller](https://alert.psychnews.org/tag/prescription-painkiller)

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