The Consolidated Framework for Implementation Research structured a qualitative analysis of features of extended-release naltrexone that inhibited use for the treatment of alcohol and opioid use disorders.

The processes of ordering, storing, and using and the cost of extended-release naltrexone were characteristics of the intervention that reduced use.

Features of the outer setting (environment) that inhibited use included requirements for patients with opioid use disorders to be opioid free for 7 to 10 days and health plan formulary, benefit management, and reimbursement policies.

Program cultures, resistance to change, and weak linkages with primary care for ongoing injections also affected routine use of the medication.