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Naltrexone vs Buprenorphine-Naloxone for Opioid Dependence in Norway

Phase 3
Completed
Conditions
Opioid Dependence
Interventions
Drug: Buprenorphine-naloxone
Registration Number
NCT01717963
Lead Sponsor
University of Oslo
Brief Summary

Persons dependent on opioids like heroin, morphine, or codeine have a high risk of relapse, overdose and overdose death. This risk is elevated even further following discharge from treatment or correctional institutions where patients have been detoxified. At the moment, state-of-the-art treatment is based on maintaining the dependence on opioids by daily intake of opioid medications like methadone or buprenorphine. Recently, a medication containing the blocking agent naltrexone was approved in the US; this does not maintain dependence but instead blocks heroin and other opioids for 28 days after intramuscular administration. This study will conduct a 12-week randomized comparison of naltrexone intramuscular suspension (XL-NTX) with daily buprenorphine-naloxone in OMT. Medication will start preceding discharge from a treatment or correctional facility to participating catchment regions in Norway. The main hypotheses are that XL-NTX will do equally well as - or better than - OMT on the proportion of biological samples negative for opioids, retention, self-reported use of alcohol and illicit drugs. Following the 12-week randomized period, there will be a 36-week period where participants can receive the study medication of their choice. After the end of the study, data from national registry databases can be collected for a further 12 months on outcomes such as recidivism, mortality and morbidity.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
166
Inclusion Criteria
  • Opioid dependence (DSM-IV TR)
  • Age 18 or above
  • Applied & Approved for Norway's national OMT program
  • Discharge within 30 days of inclusion from a controlled environment; e.g. inpatient treatment or correctional (prison) facility
  • Voluntarily seeking treatment for opioid dependence
Exclusion Criteria
  • Pregnant or breast-feeding
  • Acute or recurring severe psychiatric disorder, e.g. psychosis, suicidality
  • Serious debilitation of liver or renal function (e.g. Child-Pugh level C)
  • Use of excluded medication
  • Known intolerance to study drugs or their ingredients
  • Employment in firm manufacturing one of the study drugs or close relation to such person

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Naltrexone intramuscular suspensionNaltrexone intramuscular suspensionExtended release naltrexone injections 380mg
Buprenorphine-naloxoneBuprenorphine-naloxoneFlexible oral dose 4-24 mg daily
Primary Outcome Measures
NameTimeMethod
Number of biological samples negative/positive for opioid agonistsWeek 1-12 post discharge
RetentionWeek 1-12 post discharge
Days of use or abstinence from opioidsWeek 1-12 post discharge
Secondary Outcome Measures
NameTimeMethod
Mental healthWeek 1-12 or 1-48

Self-reported mental health

Somatic healthWeek 1-12 or 1-48 post discharge

Self-reported and/or assessed by study personnel

Use of other substances of abuseWeek 1-48
Psychosocial problemsWeek 1-12, Week 1-48, & Wk 49-100

Psychosocial problems like recidivism, employment, family problems. Self-reported or registry-based.

Trial Locations

Locations (5)

Stavanger University Hospital

🇳🇴

Stavanger, Rogaland, Norway

Akershus University Hospital

🇳🇴

Oslo, Akershus, Norway

Vestfold Hospital Trust

🇳🇴

Tonsberg, Vestfold, Norway

Haukeland University Hospital

🇳🇴

Bergen, Hordaland, Norway

Oslo University Hospital, Avdeling for Rus og Avhengighet

🇳🇴

Oslo, Norway

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