Life satisfaction among individuals with opioid use disorder receiving extended-release naltrexone: A 12-week randomized controlled trial and a 36-week follow-up
Abstract
People with an opioid use disorder have lower life satisfaction compared to the general population. Our study examines changes in life satisfaction during short- and longer-term treatment with extended-release naltrexone (XR-NTX). In the open-label, 12-week clinical trial, 159 participants were randomized to either monthly XR-NTX or daily buprenorphine-naloxone (BP-NLX). In the subsequent 36-week follow-up study, participants either continued or switched to XR-NTX. Data on the Temporary Satisfaction with Life (TSWL) and illicit opioid use were collected every fourth week. Changes in life satisfaction were assessed using a linear mixed model and growth mixture model. The relationship between life satisfaction and opioid use was assessed using a linear mixed model. In the trial, TSWL scores were significantly higher in the XR-NTX group at week 4 (p=0.013) and week 8 (p=0.002) compared with the BP-NLX group. In the follow-up period, TSWL scores were significantly higher in the XR-NTX-continuing group at week 16 (p=0.031) and week 48 (p=0.025). A lower mean TSWL score was associated with increased opioid use. Low and high life satisfaction groups were identified. In the trial period, TSWL scores showed a significant increase from baseline up to week 12 in both groups, p<0.001 and p=0.011 in the low and high life satisfaction group, respectively. In the follow-up period, TSWL scores showed a significant increase from week 16 to 48 (p=0.003) in the high life satisfaction group, while values remained consistently low in the low life satisfaction group. Higher life satisfaction was associated with XR-NTX treatment compared to BP-NLX. Most participants reported lower baseline life satisfaction that did not change with longer treatment. Low or decreasing life satisfaction has been associated with frequent illicit opioid use.