Naltrexone vs Buprenorphine-Naloxone for Opioid Dependence in Norway (NTX-SBX)

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2015 by University of Oslo
The Research Council of Norway
The Royal Norwegian Ministry of Health
Norwegian Institute of Public Health
Oslo University Hospital
University Hospital, Akershus
Haukeland University Hospital
Helse Stavanger HF
The Hospital of Vestfold
Ostfold Hospital Trust
Information provided by (Responsible Party):
Lars Tanum, University of Oslo Identifier:
First received: October 28, 2012
Last updated: April 7, 2015
Last verified: April 2015
Persons dependent on opioids like heroin, morphine, or codeine have a high risk of overdose and overdose death. This risk is elevated even further following discharge from treatment or correctional institutions where patients have been detoxified. At the moment, state-of-the-art treatment is based on maintaining the dependence on opioids by daily intake of opioid medications like methadone or buprenorphine. Recently, a medication containing the blocking agent naltrexone was approved in the US; this does not maintain dependence but instead blocks heroin and other opioids for 28 days after intramuscular administration. This study will conduct a 12-week randomized comparison of naltrexone intramuscular suspension (XL-NTX) with daily buprenorphine-naloxone in OMT. Medication will start preceding discharge from a treatment or correctional facility to participating catchment regions in Norway. The main hypotheses are that XL-NTX will do equally well as - or better than - OMT on the proportion of biological samples negative for opioids, retention, self-reported use of alcohol and illicit drugs. Following the 12-week randomized period, there will be a 36-week period where participants can receive the study medication of their choice. In addition to the randomized groups, persons who fulfill inclusion criteria but decline medical treatment for opioid dependence will be asked to participate in an unrandomized control group without study medication and with less frequent data collection. After the end of the study, data from national registry databases can be collected for a further 12 months on outcomes such as recidivism, mortality and morbidity.

Condition Intervention Phase
Opioid Dependence
Drug: Naltrexone intramuscular suspension
Drug: Buprenorphine-naloxone
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Optimal Prevention of Overdose Deaths and Opioid Relapse Following Discharge: A Multi-Center RCT of Naltrexone Versus Buprenorphine in Norway

Resource links provided by NLM:

Further study details as provided by University of Oslo:

Primary Outcome Measures:
  • Number of biological samples negative/positive for opioid agonists [ Time Frame: Week 1-12 post discharge ] [ Designated as safety issue: No ]
  • Retention [ Time Frame: First 12 weeks post discharge ] [ Designated as safety issue: Yes ]
  • Mortality [ Time Frame: Week 1-48 ] [ Designated as safety issue: No ]
    A mortality comparison is made between medicated groups (pooled together) and the non-medicated group

Secondary Outcome Measures:
  • Use of other substances of abuse [ Time Frame: Week 1-48 ] [ Designated as safety issue: No ]
  • Mental health [ Time Frame: Week 1-12 or 1-48 ] [ Designated as safety issue: No ]
    Self-reported mental health

  • Somatic health [ Time Frame: Week 1-12 or 1-48 post discharge ] [ Designated as safety issue: No ]
    Self-reported and/or assessed by study personnel

  • Psychosocial problems [ Time Frame: Week 1-12, Week 1-48, & Wk 49-100 ] [ Designated as safety issue: No ]
    Psychosocial problems like recidivism, employment, family problems. Self-reported or registry-based.

Estimated Enrollment: 220
Study Start Date: October 2012
Estimated Study Completion Date: May 2016
Estimated Primary Completion Date: September 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Naltrexone intramuscular suspension Drug: Naltrexone intramuscular suspension
A standard dosage of 380 mg / month of naltrexone intramuscular suspension will be administered
Other Names:
  • Long-acting naltrexone
  • Extended-release naltrexone
  • XR-NTX
  • Vivitrol
Active Comparator: Buprenorphine-naloxone Drug: Buprenorphine-naloxone
Buprenorphine-naloxone is administered daily and provided in accordance with existing guidelines for OMT in Norway (treatment-as-usual).
Other Name: Suboxone
No Intervention: Voluntarily unmedicated
Participants in this group are opioid dependent but express no interest in medical treatment at time of inclusion. They consent to a limited collection of data in the study and are not randomized to a study medication.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Opioid dependence (DSM-IV TR)
  • Age 18 or above
  • Applied & Approved for Norway's national OMT program
  • Discharge within 30 days of inclusion from a controlled environment; e.g. inpatient treatment or correctional (prison) facility
  • Voluntarily seeking treatment for opioid dependence

Exclusion Criteria:

  • Pregnant or breast-feeding
  • Acute or recurring severe psychiatric disorder, e.g. psychosis, suicidality
  • Serious debilitation of liver or renal function (e.g. Child-Pugh level C)
  • Use of excluded medication
  • Known intolerance to study drugs or their ingredients
  • Employment in firm manufacturing one of the study drugs or close relation to such person
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01717963

Contact: Lars Tanum, MD, PhD
Contact: Nikolaj Kunøe, PhD

Akershus University Hospital Recruiting
Oslo, Akershus, Norway
Contact: Lars Tanum, MD, PhD, DmSci   
Principal Investigator: Lars Tanum, MD, PhD, DmSci         
Sub-Investigator: Zill-e-Huma Latif, MD         
Haukeland University Hospital Recruiting
Bergen, Hordaland, Norway
Contact: Arild Opheim   
Principal Investigator: Ola Jøsendal, MD, PhD         
Stavanger University Hospital Recruiting
Stavanger, Rogaland, Norway
Contact: Sverre Nesvåg, PhD   
Principal Investigator: Kristian Larsen, MD         
Vestfold Hospital Trust Recruiting
Tonsberg, Vestfold, Norway
Contact: Kamni Sharma, MD   
Principal Investigator: Kamni Sharma, MD         
Oslo University Hospital, Avdeling for Rus og Avhengighet Recruiting
Oslo, Norway, 0407
Contact: Kristin K Solli, MPhil   
Principal Investigator: Peter Krajci, MD         
Sub-Investigator: Kristin K Solli, MPhil         
Sponsors and Collaborators
University of Oslo
The Research Council of Norway
The Royal Norwegian Ministry of Health
Norwegian Institute of Public Health
Oslo University Hospital
University Hospital, Akershus
Haukeland University Hospital
Helse Stavanger HF
The Hospital of Vestfold
Ostfold Hospital Trust
Principal Investigator: Lars Tanum, MD, PhD University of Oslo
  More Information

Additional Information:
No publications provided

Responsible Party: Lars Tanum, National Coordinating Investigator (PI), University of Oslo Identifier: NCT01717963     History of Changes
Other Study ID Numbers: 2011-002858-31  204725-1 
Study First Received: October 28, 2012
Last Updated: April 7, 2015
Health Authority: Norway: Norwegian Medicines Agency

Additional relevant MeSH terms:
Opioid-Related Disorders
Chemically-Induced Disorders
Mental Disorders
Substance-Related Disorders
Analgesics, Opioid
Central Nervous System Agents
Central Nervous System Depressants
Narcotic Antagonists
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Sensory System Agents
Therapeutic Uses processed this record on February 11, 2016