Feasibility and safety of extended‐release naltrexone treatment of opioid and alcohol use disorder in HIV clinics: a pilot/feasibility randomized trial

Background and aims HIV‐infected people with substance use disorders are least likely to benefit from advances in HIV treatment. Integration of extended‐release naltrexone (XR‐NTX) into HIV clinics may increase engagement in the HIV care continuum by decreasing substance use. We aimed to compare (1) XR‐NTX treatment initiation, (2) retention and (3) safety of XR‐NTX versus treatment as usual (TAU) for treating opioid use disorder (OUD) and/or alcohol use disorder (AUD) in HIV clinics. Design Non‐blinded randomized trial of XR‐NTX versus pharmacotherapy TAU. Setting HIV primary care clinics in Vancouver, BC, Canada and Chicago, IL, USA. Participants Fifty‐one HIV‐infected patients seeking treatment for OUD (n = 16), AUD (n = 27) or both OUD and AUD (n = 8). Measurements Primary outcomes were XR‐NTX initiation (receipt of first injection within 4 weeks of randomization) and retention at 16 weeks. Secondary outcomes generated point estimates for change in substance use, HIV viral suppression [HIV RNA polymerase chain reaction (pcr)