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Particular treatments effective for alcohol dependence

Medical management combined with the drug naltrexone or with a specialized behavioral therapy can be effective treatments for alcohol dependence, according to a study in the May 3 issue of JAMA.

About 8 million individuals in the U.S. currently meet diagnostic criteria for alcohol dependence (also called alcoholism), a leading preventable cause of illness and death and a major contributor to health care costs, according to background information in the article. In primary care settings, the prevalence of alcohol use disorders ranges from 20 percent to 36 percent; most of those patients are never treated and, if they are, do not receive specialty care. Several behavioral treatments and at least two medications approved by the U.S. FDA, naltrexone and acamprosate, have shown efficacy in the treatment of alcohol dependence. However, no large-scale randomized controlled study has evaluated whether combined drug treatment with or without behavioral therapy could improve outcome.

Raymond F. Anton, M.D., of the Medical University of South Carolina, Charleston, and colleagues evaluated the effectiveness in treating alcohol dependence with medical management and naltrexone, acamprosate, or both, with or without combined behavioral intervention (CBI) provided by behavioral health specialists. The trial (the COMBINE Study), conducted from January 2001 January 2004, included 1,383 recently alcohol-abstinent volunteers with a diagnosis of primary alcohol dependence. The participants were divided into 9 groups. Eight groups of patients received medical management with 16 weeks of naltrexone or acamprosate, both, and/or both placebos, with or without CBI. Medical management included sessions with a medical professional focused on enhancing medication adherence and alcohol abstinence. A ninth group received CBI only (no pills). Patients were evaluated for up to one year after treatment.

The researchers found that all groups showed substantial reduction in
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Contact: Tim Gehret
843-792-2626
JAMA and Archives Journals
2-May-2006


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