Addiction treatment during incarceration is limited, and release from incarceration presents its own set of challenges. In this QA interview, Dr. Karen Cropsey discusses effective treatment options for patients with substance use disorders transitioning to or from incarceration.

Extended-release (XR) naltrexone (Vivitrol) is FDA approved for opioid use disorder and has shown efficacy in several trials. It works best for patients who have already successfully detoxed from opioids and who are highly motivated to abstain. But what about oral naltrexone?

Extended-release (XR) naltrexone (Vivitrol) is an injectable version of naltrexone that lasts for 4 weeks and is FDA approved for opioid use disorder (OUD). Although effective, there is some concern that XR naltrexone may cause or worsen psychiatric symptoms because of its opioid blockade.

Extended-release naltrexone (Vivitrol) has had some good data, yet getting patients on it remains a challenge, because an opioid-free period is required before starting it. Understandably, practitioners get nervous when patients stabilized on buprenorphine ask to be transitioned to extended-release (XR) naltrexone.