This News of Note discusses the first FDA-approved mobile app for SUDs, called reSET-O. Classified as a mobile medical app (MMAs), reSET-O can be used as an adjunct to outpatient opioid use disorder treatment. Unlike most apps, reSET-O requires a prescription to unlock and use.

Extended-release (XR) naltrexone (Vivitrol) is an injectable version of naltrexone that lasts for 4 weeks and is FDA approved for opioid use disorder (OUD). Although effective, there is some concern that XR naltrexone may cause or worsen psychiatric symptoms because of its opioid blockade.

Extended-release naltrexone (Vivitrol) has had some good data, yet getting patients on it remains a challenge, because an opioid-free period is required before starting it. Understandably, practitioners get nervous when patients stabilized on buprenorphine ask to be transitioned to extended-release (XR) naltrexone.

Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsible, but other NMDA antagonists have not worked well in depression.

We are in the middle of an opioid crisis in the US, with many lives lost daily to opioid-related deaths. Pharmacotherapy with methadone, buprenorphine, or naltrexone represents an important tool for clinicians during this crisis. But just how good are these medications in saving lives? A recent retrospective cohort study evaluated the effects of methadone, buprenorphine, and naltrexone on all-cause and opioid-related mortality in the 12 months after an opioid overdose.