Long-acting Naltrexone for Pre-release Prisoners

Inclusion Criteria: * Adult male or female inmate at MTC, BPRU, JPRU, BCCC, or MCIW and be eligible for release within 30 days * History of opiate disorder \[meeting DSM-V criteria of dependence at the time of incarceration\] * Suitability for XR-NTX treatment as determined by medical evaluation * Currently opioid-free by history, with negative urine for all opioids and no signs of opiate withdrawal * Willingness to enroll in XR-NTX treatment in prison \[not currently in or planning to pursue agonist (methadone, buprenorphine) treatment at release\] * Planning to live in Baltimore City or County. * Inmates not meeting the opioid-dependence criterion will be eligible if they were treated in an opioid agonist treatment program during the year before incarceration Exclusion Criteria: * Liver function test levels greater than three times normal * Active medical illness that may make participation hazardous (e.g., unstable diabetes, heart disease). Adequately treated medical conditions are acceptable * Untreated psychiatric disorder that may make participation hazardous (e.g., untreated psychosis, bipolar disorder with mania). Adequately treated psychiatric disorders and appropriate psychotropic medications will be allowed * History of allergic reaction to XR-NTX * Current chronic pain diagnosis for which opioids are prescribed * Creatinine above normal limits * Pregnancy (for women) * Breast-feeding (for women) * Suicidal ideation (within the past 6-months) * Body Mass Index (…