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Behavioral therapies plus pharmacotherapies can add up to success

  • Alcoholism treatment can include behavioral therapies and/or pharmacotherapies.
  • A new study examines the effectiveness of combining communications, cue exposure and coping skills training with naltrexone in a treatment program.
  • Patients who took naltrexone during aftercare were more 'alcohol-resistant' than placebo recipients.
  • Patients who received communications, cue exposure and coping skills training were less likely to relapse than education/relaxation training recipients.

There is no singular approach to treating alcoholism. Treatment professionals can choose from an array of behavioral therapies and pharmacotherapies. However, behavioral therapies may have limited effectiveness because they do not address underlying brain processes at the neurotransmitter level.

Conversely, pharmacotherapies may have limited success because they do not address the individual's need to develop coping skills, confidence about staying abstinent in risky situations, and the appropriate responses to high-risk stimuli. A study in the November issue of Alcoholism: Clinical & Experimental Research combines elements from both approaches - naltrexone (ReVia), communication skills training (CST), and cue exposure combined with urge-specific coping skills training (CET) - into a comprehensive program and then assesses its effectiveness.

"It is generally recognized that a pharmacotherapy should not be used alone without providing some behavioral treatment or counseling," said Peter M. Monti, professor of medical sciences and director of the Center for Alcohol and Addiction Studies at Brown University, and lead author of the paper. "However, behavioral treatments are often used without pharmacotherapy for alcoholism. The usual reasons are that the patient does not want to use a medication, the counselor or treatment program does not believe that the medication would be useful for the patient, or the patient is not
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