Psychoeducational Strategies During Outpatient Transition to Extended-Release Naltrexone for Patients With Opioid Use Disorder

J Am Psychiatr Nurses Assoc. 2019 Jul/Aug;25(4):272-279. doi: 10.1177/1078390318820124. Epub 2018 Dec 20.

Abstract

BACKGROUND: The United States is experiencing an opioid epidemic. Better approaches to encourage outpatient utilization of Food and Drug Administration-approved medications for the treatment of opioid use disorder, including extended-release naltrexone (XR-NTX), are needed. Withdrawal management before initiation of XR-NTX is challenging for clinicians and patients and represents a major barrier to treatment. AIMS: To review psychoeducational strategies that support patients during outpatient withdrawal management and transition to XR-NTX. METHOD: We reviewed the literature on psychoeducational strategies used during opioid withdrawal management and described the role that nurses can play in facilitating transition to XR-NTX in a Phase 3, placebo-controlled, outpatient trial comparing induction regimens. RESULTS: Supportive interventions include general psychoeducation on addiction, overcoming ambivalence, treatment adherence, anticipating XR-NTX induction, managing psychological and physiological aspects of opioid withdrawal, risks of opioid use, and sources of support during recovery. CONCLUSIONS: Psychoeducational strategies led by nurses can promote treatment adherence during withdrawal management and induction onto XR-NTX.

Keywords: medication adherence; opioid withdrawal; psychoeducation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Delayed-Action Preparations
  • Humans
  • Naltrexone / administration & dosage
  • Naltrexone / therapeutic use*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / therapeutic use*
  • Opioid-Related Disorders / drug therapy
  • Opioid-Related Disorders / psychology*
  • Opioid-Related Disorders / therapy*
  • Outpatients / psychology*
  • Outpatients / statistics & numerical data
  • Patient Education as Topic / methods*
  • United States

Substances

  • Delayed-Action Preparations
  • Narcotic Antagonists
  • Naltrexone