StudyTaking it and getting it2018
Morgan 2018: how quickly people stop opioid addiction medicines
Morgan JR, Schackman BR, Leff JA, Linas BP, Walley AY. Injectable naltrexone, oral naltrexone, and buprenorphine utilization and discontinuation among individuals treated for opioid use disorder in a United States commercially insured population
What it found
In US commercial insurance claims, people who started naltrexone stopped sooner than people on buprenorphine/naloxone: at 30 days, 52% on the naltrexone shot and 70% on naltrexone pills had stopped, compared with 31% on buprenorphine/naloxone. Medication use overall also failed to keep pace with a fourfold rise in opioid use disorder diagnoses.
- Stopped within 30 days, naltrexone shot
- 52%
- Stopped within 30 days, naltrexone pills
- 70%
- Stopped within 30 days, buprenorphine/naloxone
- 31%
- Risk of stopping after 30 days, shot vs bup/naloxone
- HR=2.17
What they tested
Researchers used a large, nationally representative database of insurance claims (Truven Health MarketScan) for commercially insured people in the United States. They looked at how often people diagnosed with opioid use disorder got injectable naltrexone, oral naltrexone, buprenorphine/naloxone or buprenorphine alone, from 2010 to 2014.
They then compared how quickly people stopped each medicine, adjusting for other factors that could affect it.
What they found
The share of insured people diagnosed with opioid use disorder grew fourfold, from 0.12% to 0.48%. But the share of diagnosed patient-months spent on medication fell from 25% in 2010 to 16% in 2014.
Naltrexone stayed a small part of treatment. In 2014 the shot accounted for 0.2% and pills for 0.4% of diagnosed patient-months, against 13.8% for buprenorphine/naloxone.
At 30 days after starting, 52% on the shot, 70% on pills and 31% on buprenorphine/naloxone had stopped. Beyond 30 days, the naltrexone shot (HR=2.17) and pills (HR=2.54) were linked to a higher chance of stopping than buprenorphine/naloxone.
People prescribed the naltrexone shot were more often male, younger and diagnosed with another substance use disorder than people on other medicines.
Limits
- Insurance claims show prescriptions filled, not whether people took the medicine or why they stopped.
- Only commercially insured people were included, so the results may not reflect people on Medicaid or without insurance.
- People weren't randomly assigned to medicines, and those on the shot differed from others, so differences in stopping can't be pinned on the medicine alone.
What it means if you're considering naltrexone
For someone weighing naltrexone for opioid use disorder, this study shows that in everyday practice many people stop it within the first month, and more often than people on buprenorphine/naloxone. It doesn't show which medicine works better, only that people on naltrexone, especially pills, stopped sooner in real-world records.
Frequently asked questions
How many people stop Vivitrol in the first month?
In US commercial insurance claims from 2010 to 2014, 52% of people who started injectable naltrexone for opioid use disorder had stopped at 30 days. For naltrexone pills it was 70%, and for buprenorphine/naloxone 31%.
The paper
Morgan JR, Schackman BR, Leff JA, Linas BP, Walley AY. Injectable naltrexone, oral naltrexone, and buprenorphine utilization and discontinuation among individuals treated for opioid use disorder in a United States commercially insured population. J Subst Abuse Treat. 2018;85:90-96. doi:10.1016/j.jsat.2017.07.001
Read the paperdoi:10.1016/j.jsat.2017.07.001
We wrote this page from the paper's published abstract, and the study's numbers here come from there. Updated October 17, 2026.
Medical disclaimer
This page is for information only and is not medical advice, diagnosis, or treatment. Don't start, stop, or change any medicine — including naltrexone — without your prescriber. Naltrexone must not be used by people taking opioid pain medicines, people dependent on opioids, or people in opioid withdrawal (FDA label). In an emergency call 911; for crisis support call or text 988. Full medical disclaimer.