Naltrexone to retain people in treatment

In an updated version of a systematic review (Minozzi et al., 2011, 13 RCTs, N=1158)), pharmacological treatment with Naltrexone versus placebo or no pharmacological treatment in opioid dependent patients was found:

• to have a statistically significant effect only when considering only the studies with patients forced to adhere to treatment which favoured naltrexone for retention and abstinence.

A new systematic review with network meta-analysis (Lim et al., 2022, 79 RCTs) however found a significant overall effect of Naltrexone compared to control in:

• retaining patients in treatment (RR 1.54, CI 95% 1.26 - 1.90).
• The network analysis showed that Buprenorphine and Methadone appear to have superior retention to naltrexone yet based on a small number of studies.