Extended-release naltrexone is a helpful, FDA-approved medication for opioid use disorder, but research is needed to examine impacts on quality-of-life beyond opioid use. This study examined changes in quality-of-life among patients with opioid use disorder during 1 year of extended-release naltrexone treatment and 1 year later.
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Extended-release naltrexone is a helpful antagonist (i.e., opioid-blocking) medication in the treatment of opioid use disorder. Although prescribed less often than the agonist medication buprenorphine/naloxone, patients that initiate abstinence taking extended-release naltrexone show similar reductions in opioid use compared to buprenorphine/naloxone. Evidence also suggests that this medication may be particularly helpful in preventing relapse to regular opioid use early in treatment. However, it is less clear how extended-release naltrexone may impact quality of life. More research is needed, overall, on the effects of opioid use disorder medications on recovery outcomes beyond substance use. This is an important knowledge gap because it is vital for patient-centered care to address quality of life concerns as part of treatment goals. Additionally, poor quality of life is associated with worse treatment outcomes for patients with opioid use disorder, including relapse. This study measured changes in quality of life among patients with opioid use disorder over 2 years after initiating extended-release naltrexone.
Data for this study came from the Naltrec study, an open-label quasi-experimental trial. This was designed to compare long-term recovery between adult (ages 18-65) participants with moderate or severe opioid use disorder initially receiving buprenorphine/naloxone or methadone who subsequently self-selected into either extended-release naltrexone or continued with their opioid agonist treatment. The present study, however, focused only on 158 participants who self-selected into extended-release naltrexone. Data for the primary study were collected from 5 urban hospitals in Norway from September 2018-October 2022.
Participants were recruited from outpatient and detoxification clinics at participating hospitals. Upon study enrollment, participants underwent inpatient medically managed withdrawal after which they received their first dose of extended-release naltrexone. “Most” participants completed a detoxification program, but all had to be abstinent from opioids for 72 hours to receive extended-release naltrexone. Participants then received monthly injections of extended-release naltrexone for up to 1 year. Participants completed behavioral assessments every 3 months during the first year and again 6 months and 1 year after treatment ended.
Of note, drop-out rates were substantial. Participants completing assessments (by % of baseline sample size) were 58% at week 12, 49% at week 24, 35% at week 40, and 25% at week 52, the end of the 1-year trial. After the medication phase, follow-up rates improved somewhat, with 55% completing the 6-month follow-up and 46% completing the 1-year follow-up. Given the high drop-out rates, study findings should be interpreted with caution. The study did not report adjusting analyses for predictors of study drop-out (i.e., differences between participants who stayed in the study versus and those who dropped out), which could have mitigated the drop-out limitation to some degree, if they did do that, but this remains unclear.
The outcome of interest for this study was quality of life measured across 4 domains: physical health (for example, pain, energy, mobility, and sleep); psychological health (including positive feelings, concentration, and negative feelings); social relationships (such as relations and support); and environment (for instance, safety and home/living conditions). The authors also conducted semi-structured interviews to determine addiction severity and mental distress. These were measured to determine how these factors may have impacted the association between extended-release naltrexone treatment and quality of life. The goal of the analyses was to examine how quality of life changed over time for patients with opioid use disorders who opted for extended-release naltrexone treatment. In addition to the high drop-out rates, another limitation was the absence of a comparison group, making it difficult to attribute any changes in quality of life specifically to extended-release naltrexone treatment.
Participants’ quality of life increased between the start of extended-release naltrexone therapy and the 1-year follow-up (see graph below). These improvements remained stable for up to 2 years after starting treatment. Even after accounting for severity of substance use disorder and mental distress, quality of life remained improved, with one exception: environmental quality of life was not significantly better at follow-up. This suggests that although extended-release naltrexone treatment may be associated with improvements in individual quality of life indicators like health and wellbeing, it may have limited impact on contextual determinants of quality of life like living conditions.
As mentioned above, however, these results should be considered with caution given the study dropout rate. It is possible that these participants staying in the study were more likely to have had positive experiences with the medication, and therefore higher quality of life. Those who discontinued extended-release naltrexone may have experienced different changes in quality of life, but these data are not available.
This study suggests that patients with opioid use disorder who choose extended-release naltrexone as part of their treatment may experience sustained improvements in quality of life. Such improvements may be due to patients having the ability to choose a treatment option that works best for them. This interpretation of findings is supported by research showing that patient autonomy can improve treatment adherence and treatment satisfaction. However, study results should be interpreted with caution given the high dropout rate. It is plausible that the patients who remained in the study reacted better to extended-release naltrexone treatment than those who withdrew from the study, or were otherwise very motivated, inflating the apparent quality of life gains. Other (i.e., secondary) analyses with the same primary study data somewhat support this claim: participants who discontinued extended-release naltrexone before the first follow-up reported more opioid use and lower treatment satisfaction than those who continued using extended-release naltrexone. Finally, because there was no comparison group in this study, there is no way to determine if patients receiving other opioid use disorder medications, or no medication at all, or used other methods, experienced different quality of life changes than those receiving extended-release naltrexone.
It is also worth noting that studies of agonist treatments like buprenorphine/naloxone and monthly injectable buprenorphine have documented improvements in health and well-being beyond opioid use. Further work is needed to determine how quality of life may vary among patients undergoing different types of opioid use disorder medications and other treatments.
Patients receiving treatment for opioid use disorders may experience improved quality of life if they incorporate extended-release naltrexone into their treatment regimen. Given the high drop-out rate in this study, however, more research is needed to examine the exact impacts of opioid use disorder medications on recovery outcomes beyond opioid use.
Redondo, C. L., Weimand, B., Benth, J. Š., Vederhus, J. K., Mordal, J., Enger, A., Tanum, L., & Solli, K. K. (2025). Changes in quality of life during 52 weeks of extended-release naltrexone treatment, subsequent by a 1-year post-treatment period. Drug and Alcohol Dependence, 276. doi: 10.1016/j.drugalcdep.2025.112917.
l
Extended-release naltrexone is a helpful antagonist (i.e., opioid-blocking) medication in the treatment of opioid use disorder. Although prescribed less often than the agonist medication buprenorphine/naloxone, patients that initiate abstinence taking extended-release naltrexone show similar reductions in opioid use compared to buprenorphine/naloxone. Evidence also suggests that this medication may be particularly helpful in preventing relapse to regular opioid use early in treatment. However, it is less clear how extended-release naltrexone may impact quality of life. More research is needed, overall, on the effects of opioid use disorder medications on recovery outcomes beyond substance use. This is an important knowledge gap because it is vital for patient-centered care to address quality of life concerns as part of treatment goals. Additionally, poor quality of life is associated with worse treatment outcomes for patients with opioid use disorder, including relapse. This study measured changes in quality of life among patients with opioid use disorder over 2 years after initiating extended-release naltrexone.
Data for this study came from the Naltrec study, an open-label quasi-experimental trial. This was designed to compare long-term recovery between adult (ages 18-65) participants with moderate or severe opioid use disorder initially receiving buprenorphine/naloxone or methadone who subsequently self-selected into either extended-release naltrexone or continued with their opioid agonist treatment. The present study, however, focused only on 158 participants who self-selected into extended-release naltrexone. Data for the primary study were collected from 5 urban hospitals in Norway from September 2018-October 2022.
Participants were recruited from outpatient and detoxification clinics at participating hospitals. Upon study enrollment, participants underwent inpatient medically managed withdrawal after which they received their first dose of extended-release naltrexone. “Most” participants completed a detoxification program, but all had to be abstinent from opioids for 72 hours to receive extended-release naltrexone. Participants then received monthly injections of extended-release naltrexone for up to 1 year. Participants completed behavioral assessments every 3 months during the first year and again 6 months and 1 year after treatment ended.
Of note, drop-out rates were substantial. Participants completing assessments (by % of baseline sample size) were 58% at week 12, 49% at week 24, 35% at week 40, and 25% at week 52, the end of the 1-year trial. After the medication phase, follow-up rates improved somewhat, with 55% completing the 6-month follow-up and 46% completing the 1-year follow-up. Given the high drop-out rates, study findings should be interpreted with caution. The study did not report adjusting analyses for predictors of study drop-out (i.e., differences between participants who stayed in the study versus and those who dropped out), which could have mitigated the drop-out limitation to some degree, if they did do that, but this remains unclear.
The outcome of interest for this study was quality of life measured across 4 domains: physical health (for example, pain, energy, mobility, and sleep); psychological health (including positive feelings, concentration, and negative feelings); social relationships (such as relations and support); and environment (for instance, safety and home/living conditions). The authors also conducted semi-structured interviews to determine addiction severity and mental distress. These were measured to determine how these factors may have impacted the association between extended-release naltrexone treatment and quality of life. The goal of the analyses was to examine how quality of life changed over time for patients with opioid use disorders who opted for extended-release naltrexone treatment. In addition to the high drop-out rates, another limitation was the absence of a comparison group, making it difficult to attribute any changes in quality of life specifically to extended-release naltrexone treatment.
Participants’ quality of life increased between the start of extended-release naltrexone therapy and the 1-year follow-up (see graph below). These improvements remained stable for up to 2 years after starting treatment. Even after accounting for severity of substance use disorder and mental distress, quality of life remained improved, with one exception: environmental quality of life was not significantly better at follow-up. This suggests that although extended-release naltrexone treatment may be associated with improvements in individual quality of life indicators like health and wellbeing, it may have limited impact on contextual determinants of quality of life like living conditions.
As mentioned above, however, these results should be considered with caution given the study dropout rate. It is possible that these participants staying in the study were more likely to have had positive experiences with the medication, and therefore higher quality of life. Those who discontinued extended-release naltrexone may have experienced different changes in quality of life, but these data are not available.
This study suggests that patients with opioid use disorder who choose extended-release naltrexone as part of their treatment may experience sustained improvements in quality of life. Such improvements may be due to patients having the ability to choose a treatment option that works best for them. This interpretation of findings is supported by research showing that patient autonomy can improve treatment adherence and treatment satisfaction. However, study results should be interpreted with caution given the high dropout rate. It is plausible that the patients who remained in the study reacted better to extended-release naltrexone treatment than those who withdrew from the study, or were otherwise very motivated, inflating the apparent quality of life gains. Other (i.e., secondary) analyses with the same primary study data somewhat support this claim: participants who discontinued extended-release naltrexone before the first follow-up reported more opioid use and lower treatment satisfaction than those who continued using extended-release naltrexone. Finally, because there was no comparison group in this study, there is no way to determine if patients receiving other opioid use disorder medications, or no medication at all, or used other methods, experienced different quality of life changes than those receiving extended-release naltrexone.
It is also worth noting that studies of agonist treatments like buprenorphine/naloxone and monthly injectable buprenorphine have documented improvements in health and well-being beyond opioid use. Further work is needed to determine how quality of life may vary among patients undergoing different types of opioid use disorder medications and other treatments.
Patients receiving treatment for opioid use disorders may experience improved quality of life if they incorporate extended-release naltrexone into their treatment regimen. Given the high drop-out rate in this study, however, more research is needed to examine the exact impacts of opioid use disorder medications on recovery outcomes beyond opioid use.
Redondo, C. L., Weimand, B., Benth, J. Š., Vederhus, J. K., Mordal, J., Enger, A., Tanum, L., & Solli, K. K. (2025). Changes in quality of life during 52 weeks of extended-release naltrexone treatment, subsequent by a 1-year post-treatment period. Drug and Alcohol Dependence, 276. doi: 10.1016/j.drugalcdep.2025.112917.
l
Extended-release naltrexone is a helpful antagonist (i.e., opioid-blocking) medication in the treatment of opioid use disorder. Although prescribed less often than the agonist medication buprenorphine/naloxone, patients that initiate abstinence taking extended-release naltrexone show similar reductions in opioid use compared to buprenorphine/naloxone. Evidence also suggests that this medication may be particularly helpful in preventing relapse to regular opioid use early in treatment. However, it is less clear how extended-release naltrexone may impact quality of life. More research is needed, overall, on the effects of opioid use disorder medications on recovery outcomes beyond substance use. This is an important knowledge gap because it is vital for patient-centered care to address quality of life concerns as part of treatment goals. Additionally, poor quality of life is associated with worse treatment outcomes for patients with opioid use disorder, including relapse. This study measured changes in quality of life among patients with opioid use disorder over 2 years after initiating extended-release naltrexone.
Data for this study came from the Naltrec study, an open-label quasi-experimental trial. This was designed to compare long-term recovery between adult (ages 18-65) participants with moderate or severe opioid use disorder initially receiving buprenorphine/naloxone or methadone who subsequently self-selected into either extended-release naltrexone or continued with their opioid agonist treatment. The present study, however, focused only on 158 participants who self-selected into extended-release naltrexone. Data for the primary study were collected from 5 urban hospitals in Norway from September 2018-October 2022.
Participants were recruited from outpatient and detoxification clinics at participating hospitals. Upon study enrollment, participants underwent inpatient medically managed withdrawal after which they received their first dose of extended-release naltrexone. “Most” participants completed a detoxification program, but all had to be abstinent from opioids for 72 hours to receive extended-release naltrexone. Participants then received monthly injections of extended-release naltrexone for up to 1 year. Participants completed behavioral assessments every 3 months during the first year and again 6 months and 1 year after treatment ended.
Of note, drop-out rates were substantial. Participants completing assessments (by % of baseline sample size) were 58% at week 12, 49% at week 24, 35% at week 40, and 25% at week 52, the end of the 1-year trial. After the medication phase, follow-up rates improved somewhat, with 55% completing the 6-month follow-up and 46% completing the 1-year follow-up. Given the high drop-out rates, study findings should be interpreted with caution. The study did not report adjusting analyses for predictors of study drop-out (i.e., differences between participants who stayed in the study versus and those who dropped out), which could have mitigated the drop-out limitation to some degree, if they did do that, but this remains unclear.
The outcome of interest for this study was quality of life measured across 4 domains: physical health (for example, pain, energy, mobility, and sleep); psychological health (including positive feelings, concentration, and negative feelings); social relationships (such as relations and support); and environment (for instance, safety and home/living conditions). The authors also conducted semi-structured interviews to determine addiction severity and mental distress. These were measured to determine how these factors may have impacted the association between extended-release naltrexone treatment and quality of life. The goal of the analyses was to examine how quality of life changed over time for patients with opioid use disorders who opted for extended-release naltrexone treatment. In addition to the high drop-out rates, another limitation was the absence of a comparison group, making it difficult to attribute any changes in quality of life specifically to extended-release naltrexone treatment.
Participants’ quality of life increased between the start of extended-release naltrexone therapy and the 1-year follow-up (see graph below). These improvements remained stable for up to 2 years after starting treatment. Even after accounting for severity of substance use disorder and mental distress, quality of life remained improved, with one exception: environmental quality of life was not significantly better at follow-up. This suggests that although extended-release naltrexone treatment may be associated with improvements in individual quality of life indicators like health and wellbeing, it may have limited impact on contextual determinants of quality of life like living conditions.
As mentioned above, however, these results should be considered with caution given the study dropout rate. It is possible that these participants staying in the study were more likely to have had positive experiences with the medication, and therefore higher quality of life. Those who discontinued extended-release naltrexone may have experienced different changes in quality of life, but these data are not available.
This study suggests that patients with opioid use disorder who choose extended-release naltrexone as part of their treatment may experience sustained improvements in quality of life. Such improvements may be due to patients having the ability to choose a treatment option that works best for them. This interpretation of findings is supported by research showing that patient autonomy can improve treatment adherence and treatment satisfaction. However, study results should be interpreted with caution given the high dropout rate. It is plausible that the patients who remained in the study reacted better to extended-release naltrexone treatment than those who withdrew from the study, or were otherwise very motivated, inflating the apparent quality of life gains. Other (i.e., secondary) analyses with the same primary study data somewhat support this claim: participants who discontinued extended-release naltrexone before the first follow-up reported more opioid use and lower treatment satisfaction than those who continued using extended-release naltrexone. Finally, because there was no comparison group in this study, there is no way to determine if patients receiving other opioid use disorder medications, or no medication at all, or used other methods, experienced different quality of life changes than those receiving extended-release naltrexone.
It is also worth noting that studies of agonist treatments like buprenorphine/naloxone and monthly injectable buprenorphine have documented improvements in health and well-being beyond opioid use. Further work is needed to determine how quality of life may vary among patients undergoing different types of opioid use disorder medications and other treatments.
Patients receiving treatment for opioid use disorders may experience improved quality of life if they incorporate extended-release naltrexone into their treatment regimen. Given the high drop-out rate in this study, however, more research is needed to examine the exact impacts of opioid use disorder medications on recovery outcomes beyond opioid use.
Redondo, C. L., Weimand, B., Benth, J. Š., Vederhus, J. K., Mordal, J., Enger, A., Tanum, L., & Solli, K. K. (2025). Changes in quality of life during 52 weeks of extended-release naltrexone treatment, subsequent by a 1-year post-treatment period. Drug and Alcohol Dependence, 276. doi: 10.1016/j.drugalcdep.2025.112917.
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