Evidence for the intervention

Naltrexone is one of three FDA-approved evidence-based medications for opioid use disorder. Data supporting naltrexone comes from randomized clinical trials and observational studies. Trials have generally found that once naltrexone is successfully initiated, it is effective for reducing opioid use. However, naltrexone is complicated to initiate for many individuals because of its requirement for a longer period of medically supervised withdrawal or opioid abstinence. Both randomized trials and observational studies find that naltrexone is less effective than buprenorphine or methadone for reducing opioid use and the risk of overdose death among patients who have not stopped using opioids. Its effectiveness is more comparable to other medication options when compared after the patient has stopped using opioids. Naltrexone is more effective than not taking any medications for opioid use disorder.