A study of predictors of retention to naltrexone maintenance therapy in patients with opioid use disorder: a prospective study

Abstract

Naltrexone prophylaxis is a well-established treatment for opioid use disorder. Our study aimed to track patients on naltrexone and investigate the factors predictive of retention. The study comprised 100 participants initiated on naltrexone, who underwent a 12-week follow-up. We analyzed a range of socio-demographic and clinical variables at 04 and 12 weeks to compare those who remained in treatment program with those who experienced relapse. The results revealed a predominantly young, unmarried, male, rural-dwelling sample with heroin as the primary opioid. Intravenous use was common (75%), with 57% of the participants exhibiting positive serology results for infections by hepatitis C (HCV), hepatitis B (HBV), and/or human immunodeficiency virus (HIV), and a significant proportion initiating opioids before the age of 20 (31%). The retention rates at 04 and 12 weeks were 83% and 64%, respectively. Several socio-clinical factors including age of initiation of use, rural residence, and comorbid psychiatric illness significantly influenced retention at 04 and 12 weeks. The findings highlight the importance of tailored interventions that take into consideration the age, residence, socio-economic status, and psychiatric comorbidity to enhance retention rates. Identifying these factors can help improve the effectiveness of treatment programs and promote sustained recovery efforts.