Real-World Effectiveness of Long-Acting Injectable Versus Oral Naltrexone for Co-Occurring Post-Traumatic Stress Disorder and Alcohol Use Disorder
Abstract
Both post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are major public health concerns in the United States that especially impact the Veteran population. PTSD is one of the most common mental health problems among Service Members and Veterans returning from deployment, and a quarter of U.S. Department of Veterans Affairs (VA) patients with PTSD have AUD. There are several recommended treatments for patients with PTSD and AUD, but unfortunately, many patients do not take the medications as prescribed, thus reducing their effectiveness. As a result, it is crucial to identify effective treatments that also increase treatment adherence. As a potential way to improve treatment adherence, this proposal addresses the FY21 PRMRP topic area of Sustained Release Drug Delivery for PTSD, substance use, and suicidality. This proposal will build off the success of our currently funded project, which allowed us to create the largest available database on the delivery of PTSD treatment in the VA, and provides us with a unique opportunity to study the effectiveness of two different formulations of naltrexone, a medication used to treat AUD, for patients with both AUD and PTSD. We will use this dataset to understand how well the monthly sustained release injectable versus daily oral formulation works to treat PTSD symptoms, decrease alcohol consumption, and prevent adverse mental health outcomes such as suicide attempts. Current research on co-occurring PTSD and AUD is scarce and contradictory. Naltrexone has previously been identified as an effective treatment for AUD, but poor adherence reduces its effectiveness. Similarly, individuals with PTSD are less likely to adhere to medications than those without PTSD. A sustained release injectable medication may aid in adherence due to the long-acting nature of the medication, which in turn may improve outcomes for both PTSD and AUD. This project will help Veterans and active-duty personnel who have both PTSD and AUD. By understanding how sustained release naltrexone compares to oral naltrexone in routine clinical practice, we may be able to improve treatment recommendations and mental health outcomes for patients with PTSD and AUD. Furthermore, study findings will be presented to other researchers and clinicians in an effort to inform the healthcare community about the effectiveness of sustained release medication formulations more generally, and to improve the design of prospective studies of treatments for PTSD and AUD.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210641
Entities
People
- Brian Shiner
Organizations
- United States Army
- Veterans Education and Research Association of Northern New England