Vivitrol packaging. Photo: Carla K. Johnson / AP

The first study in the U.S. to directly compare two medications to treat opioid addiction — one injected monthly, one given daily as a film placed under the tongue — found the treatments are equally effective, according to research published in the Lancet on Tuesday.

Yes but: Naltrexone (or Vivitrol) injections can't begin until someone has detoxed, typically after a few days. In the study, 28 percent of the participants who were to receive naltrexone didn't detox and couldn't begin the treatment.

What it means: Increasing access to medications for treating opioid addiction was a top recommendation from President Trump's opioid crisis commission. One potential advantage of naltrexone for some patients is that it is a monthly shot versus a daily treatment. Until now, there was limited data about the medication's effectiveness. "We need as many evidence-based options as possible because opioid abuse disorder is more deadly and affecting more people," says Alex Walley, a physician and researcher at Boston Medical Center's Grayken Center for Addiction, who was not involved in the study. He says detox programs should be offering both treatments and allowing patients and their physicians to choose.

What they did: 570 people who had used illegal opioids, mostly heroin, were recruited from inpatient treatment clinics in eight different locations across the U.S. Roughly half of the people in the study received monthly shots of Vivitrol, and the other half took buprenorphine and naloxone (Suboxone) at home each day.

The researchers then tracked any relapses, overdoses, and deaths in the groups over the following 24 weeks. 52 percent of the people that were able to detox and receive naltrexone relapsed during the next six months versus 56 percent of the group that received Suboxone. "We need to think of staying on medication as an important outcome," says Walley.

The big question: What happens long-term? Nora Volkow, director of the National Institute on Drug Abuse, which funded the trial, says they want to understand the characteristics of patients that determine if they will respond better to one treatment versus another. They also want to know how protocols used by centers to initiate treatments might be standardized and improved.

Editor's note: This story has been corrected. In the study, Suboxone was administered daily as a film placed under the tongue, not a pill.

Go deeper

Louisville officer: "Breonna Taylor would be alive" if we had served no-knock warrant

Breonna Taylor memorial in Louisville. Photo: Brandon Bell/Getty Images

Sgt. Jonathan Mattingly, the Louisville officer who led the botched police raid that caused the death of Breonna Taylor, said the No. 1 thing he wishes he had done differently is either served a "no-knock" warrant or given five to 10 seconds before entering the apartment: "Breonna Taylor would be alive, 100 percent."

Driving the news: Mattingly, who spoke to ABC News and Louisville's Courier Journal for his public interview, was shot in the leg in the initial moments of the March 13 raid. Mattingly did not face any charges after Kentucky Attorney General Daniel Cameron said he and another officer were "justified" in returning fire to protect themselves against Taylor's boyfriend.

U.S. vs. Google — the siege begins

Illustration: Sarah Grillo/Axios

The Justice Department fired the starter pistol on what's likely to be a years-long legal siege of Big Tech by the U.S. government when it filed a major antitrust suit Tuesday against Google.

The big picture: Once a generation, it seems, federal regulators decide to take on a dominant tech company. Two decades ago, Microsoft was the target; two decades before that, IBM.

Dion Rabouin, author of Markets
2 hours ago - Economy & Business

Why the stimulus delay isn't a crisis (yet)

Illustration: Aïda Amer/Axios

If the impasse between House Speaker Nancy Pelosi and the White House on a new stimulus deal is supposed to be a crisis, you wouldn't know it from the stock market, where prices continue to rise.

  • That's been in no small part because U.S. economic data has held up remarkably well in recent months thanks to the $2 trillion CARES Act and Americans' unusual ability to save during the crisis.