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Psych Congress  

The effect of extended release naltrexone on alcohol related admissions and length of stay, when used as adjunctive in alcohol dependence, at a university affiliated VAMC.

Wilfred Acholonu, Jr., Pharm.D., M.S.P, BCPP. Leonardo Rodriguez, MD, Psychiatrist. Babu Rankupalli, MD, Psychiatrist. Matthew Morrow, PharmD. Babu Rankupalli, MD, Psychiatrist

Naltrexone extended-release (ER) injection, a depot opioid antagonist, is shown as safe and effective adjunctive in treatment of alcohol-dependence. Evidence is sparse regarding its effects on alcohol-related admissions and length-of-stay. The purpose of this study was to investigate effects of Naltrexone-ER on alcohol related admissions and length-of-stay of veterans at the North-Florida/South-Georgia Veterans-Health-System (NF/SG-VHS). 
Computer generated data provided list of patients who received Naltrexone-ER Injections between April 2006 and December 2009. Medical records were reviewed for alcohol-related-admissions and length-of-stay from the international-classification of diseases (ICD-9) procedure codes. Number of ICD-codes and length-of-stay , two years prior and two years post Naltrexone-ER initiation were determined for each patient and compared using paired student t-test 
Seventy-nine alcohol-dependent patients, 77 males and 2 females, 30-83 years old, received one or more doses of Naltrexone-ER. Mean number of doses received was 4 ±0.45(Se). Number of alcohol related admissions decreased by 37% {mean 2.16±0.36(se)} P≤0.005, and length-of-stay decreased by 45% {mean 22.20±4.67(se)} days, P≤0.023 after Naltrexone-ER injections. Patients who received four or more doses showed significant reduction, 51%, P≤ 0.036 in alcohol related admissions, and in length-of-stay, 59%, P≤ 0.013. The proportion of patients who showed either reduction or no worsening in admission rate, or length-of stay was 82% and 75%, respectively.
In this retrospective study, Naltrexone-ER was associated with reduction in ethanol related admissions and length of stay when used as adjunctive in management of alcohol dependence. The result of this trial may need confirmation by prospective randomized clinical trial.

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