Predictors of Retention in Naltrexone Maintenance for Opioid Dependence: Analysis of a Stage I Trial

Behavioral naltrexone therapy (BNT) was developed to address the shortcomings of naltrexone maintenance for opiate dependence and improve compliance by integrating several empirically validated methods, including the use of a significant other to monitor compliance, voucher incentives, and motivatio...

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Bibliographic Details
Published in:The American journal on addictions 2006-03, Vol.15 (2), p.150-159
Main Authors: Sullivan, Maria A., Rothenberg, Jami L., Vosburg, Suzanne K., Church, Sarah H., Feldman, Shara J., Epstein, Eva M., Kleber, Herbert D., Nunes, Edward V.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Behavior Therapy
Combined Modality Therapy
Female
Follow-Up Studies
Heroin Dependence - psychology
Heroin Dependence - rehabilitation
Humans
Male
Methadone
Middle Aged
Naltrexone - therapeutic use
Narcotic Antagonists - therapeutic use
Opioid-Related Disorders - psychology
Opioid-Related Disorders - rehabilitation
Patient Dropouts - psychology
Patient Dropouts - statistics & numerical data
Substance Abuse, Intravenous - psychology
Substance Abuse, Intravenous - rehabilitation
Token Economy
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Summary:Behavioral naltrexone therapy (BNT) was developed to address the shortcomings of naltrexone maintenance for opiate dependence and improve compliance by integrating several empirically validated methods, including the use of a significant other to monitor compliance, voucher incentives, and motivational techniques. An uncontrolled Stage I pilot trial (N = 47) of BNT was conducted. Baseline demographic and clinical variables were evaluated as predictors of retention with univariate tests. Significant predictors were entered together into a multiple regression model. Poorer (shorter) retention in treatment was associated with methadone use and higher average bags per day of heroin. Other variables that became non-significant in multiple regression analysis included older age and depressive symptoms. Individuals with greater physiologic dependence and/or dependence on longer-acting opiates are at higher risk to drop out from naltrexone maintenance and may require a more gradual detoxification and more intensive behavioral therapy aimed at enhancing initial compliance.
ISSN:1055-0496
1521-0391
DOI:10.1080/10550490500528464