Theme: Clinical Research Year: 2022
Background:
Opioid use disorder (OUD) and injection drug use (IDU) place justice-involved individuals at
increased risk for acquiring or transmitting HIV or hepatitis C virus (HCV). Methadone and
buprenorphine have been associated with reduced opioid IDU, however the effect of extendedrelease naltrexone (XR-NTX) on this behavior is incompletely studied.
Methods:
Injection opioid use and shared injection equipment behavior was examined from a completed
double-blind placebo-controlled trial of XR-NTX among 88 justice-involved participants with HIV and
OUD. Changes in participants’ self-reported daily injection opioid use and shared injection
equipment was evaluated pre-incarceration, during incarceration and monthly post-release for 6
months. Differences in time to first opioid injection post release was also assessed. Intention to treat
and ‘as treated’ (high treatment versus low treatment) analyses were performed.
Results:
Fifty eight of 88 (65.9%) participants self-reported injection of opioids pre-incarceration and 26
(29.5%) reported sharing injection equipment. Fifty-four (61.4%) participants had an HIV RNA below
200 copies/mL and 62 (70.5%) were baseline HCV antibody positive. Participants in the high
treatment group had significantly lower mean proportion of days injecting opioids (13.8% high
treatment versus 22.8% low treatment, p=0.02) by month 1 which persisted up to 5 months post
release (0% high treatment vs 24.3% low treatment, p<0.001) and experienced a longer time to first
opioid injection post-release (143.8 days high treatment vs 67.4 days low treatment, p<0.001).
Conclusion:
Retention on XR-NTX is associated with reduced intravenous opioid use in justice-involved persons,
which has important implications for reducing transmission of HIV and HCV.
Disclosure of Interest Statement:
None