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Combining medication, family counseling improves treatment outcome for men who abuse heroin

The study showed that men in behavioral family counseling were more likely to take naltrexone on a daily basis than were those who received individual counseling only. As a result, these men were heroin-free 81 percent of their days during treatment and, more importantly, were heroin-free for 69 percent of their days during the year following treatment. The men in individual-based treatment were heroin-free 56 percent of their days during treatment and were heroin-free 49 percent of their days during the year after treatment.

"Although use of naltrexone with patients who abuse heroin is effective, few patients are willing to take it. As a result, it is very rarely prescribed in clinical practice," said Fals-Stewart. "However, family members supporting the patients' daily use of naltrexone increases their compliance and leads to better outcomes. This combination of family support with naltrexone therapy appears to be an effective method to increase compliance with this powerful and effective medication."

Fals-Stewart noted, "Our findings are consistent with the broader literature on family-involved treatment of drug abuse and alcoholism. In this study, the behavioral family counseling contract included the patient's daily naltrexone dose being witnessed by the family member who then offered verbal support. It adds to the growing evidence that the use of family observation of medication-taking is a non-coercive way to encourage compliance with pharmacotherapy and commitment to treatment and recovery."

Fals-Stewart has been invited to speak about his research at the American Psychiatric Association and the research was highlighted in a congressional subcommittee as among the "best" of the behavioral interventions for drug abuse.

Future studies will look at whether the findings would generalize to female patients living with a non-substance abusing family member or to patients of either gender living with family members who also have substance ab
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Contact: Kathleen Weaver
weaver@ria.buffalo.edu
716-887-2585
University at Buffalo
18-Nov-2003


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