Online Program

Client outcomes among drug court patients using extended-release naltrexone in los angeles county

Tuesday, November 5, 2013

Sarah J. Cousins, M.P.H., M.C.H.E.S., Intergrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA
Desiree Crevecoeur-MacPhail, Ph.D., Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles
Richard Rawson, PhD, Integrated Substance Abuse Programs, UCLA Integrated Substance Abuse Programs (ISAP), Los Angeles, CA
Loretta L. Denering, M.S., Integrated Substance Abuse Programs and School of Public Health, University of California, Los Angeles and Loma Linda University, Los Angeles, CA
Extended-release naltrexone is FDA approved for treatment of alcohol and opioid dependence when used in conjunction with psychosocial support. In 2010, Los Angeles county, collaborated with UCLA Integrated Substance Abuse Programs, conducting an evaluation on the implementation of county-funded extended-release naltrexone for clients seeking recovery from alcohol or opioids. Conclusions from this initial pilot suggested that clients receiving Vivitrol had decreased urges to use four weeks after their initial injection. However, little was known about clients' experiences after stopping the medication. Therefore, in 2012 a second pilot was initiated to examine whether clients maintained sobriety once they stop taking extended-release naltrexone. Like the first pilot, the current pilot collects data on days used and cravings to use. These assessments are collected at Weeks 0, 1, 2, 3, 8 and 12 after the first injection. The assessments are repeated at the follow-up interviews (30- and 60-days after the final extended-release naltrexone injection). This analysis of a subgroup of patients, Drug Court patients. Preliminary analysis reveals that clients decreased their days of intoxication from about five days in the past month (as reported at baseline) to two days at Follow-Up #2. Clients urge to use decreased from a score of 19 (as reported at baseline; based on an assessment scored from 0 to 30) to 7.1 at Follow-Up #2. A score of 10 or more indicates the person is in danger of relapse. The decrease in the scores demonstrates that the clients' urge to drink/use. Additional analysis will determine patient treatment outcomes.

Learning Areas:

Administer health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Define medically assisted treatment. Identify at least two benefits of medically assisted treatment in conjunction with substance abuse treatment for Drug Court patients. Compare at least one outcome of drug court patients in residential vs. outpatient treatment settings.

Keyword(s): Medicine, Criminal Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to conduct this research given my 7 years of experience in substance use disorder research and academic training in public health. The current research project was conducted by the authors to examine if clients can maintain their sobriety once they are no longer receiving medically assisted treatment. As lead author, I have overseen the project as well as assisted in the data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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