Factors associated with the percentage of individuals who initiate and discontinue naltrexone as a relapse prevention pharmacotherapy in opioid use disorder: A systematic review, meta-analysis and meta-regression.
AddictionJun 12, 2026 (epub)
Emmert Roberts, Elizabeth Sanderson, Thomas Santo et al.
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In 30 seconds
This systematic review and meta-analysis examined initiation and discontinuation rates of naltrexone for relapse prevention in opioid use disorder (OUD) among 124,016 individuals. The study found that 60.3% initiated oral naltrexone, while 50.0% discontinued it at 1 month. The evidence quality was assessed as very low.
Key findings
- 60.3% of eligible individuals initiated oral naltrexone (95% CI = 38.9%-80.0%).
- 50.0% discontinued oral naltrexone at 1 month (95% CI = 41.9%-58.1%).
- 26.1% discontinued depot naltrexone at 1 month (95% CI = 19.5%-33.3%).
- Higher initiation rates were observed when oral naltrexone was the only offered pharmacotherapy.
Why it matters
Understanding the initiation and discontinuation rates of naltrexone in OUD is crucial for improving treatment strategies. High discontinuation rates indicate a need for enhanced support and monitoring to maintain treatment adherence.
What to keep in mind
All outcomes were assessed as very low certainty, indicating potential biases and variability in the data.