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Effectiveness of naltrexone in a community treatment program
Therese K Killeen1, Kathleen T Brady, Paul B Gold
1Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA. killeent@musc.edu
Alcoholism, Clinical and Experimental Research
|November 18, 2004
Summary
Naltrexone (an opiate antagonist) showed similar alcohol use improvements for early drinkers and abstainers in community treatment. This suggests naltrexone may benefit patients continuing to drink during early treatment stages.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Psychology
Background:
- Naltrexone is an opiate antagonist proven effective for alcohol dependence in controlled studies.
- Its efficacy in community-based substance abuse treatment programs remains less established.
- Alcohol use disorder (AUD) treatment requires accessible and effective interventions.
Purpose of the Study:
- To evaluate naltrexone's efficacy in a rural community substance abuse treatment setting.
- To determine if naltrexone benefits individuals with alcohol use disorders presenting for front-line treatment.
- To assess naltrexone's impact on drinking patterns and related outcomes.
Main Methods:
- 145 patients with AUD were randomized to naltrexone, placebo, or usual treatment for 12 weeks.
- Primary outcomes included drinking days, heavy drinking, and time to relapse.
- Exploratory analyses divided participants into entry drinkers and entry abstainers.
Main Results:
- No significant differences in primary drinking outcomes between groups in intention-to-treat analysis.
- Entry abstainers showed better outcomes across all primary measures, regardless of treatment arm.
- Naltrexone-treated entry drinkers and abstainers demonstrated similar improvements in drinking outcomes.
Conclusions:
- Naltrexone may provide specific benefits for patients who continue drinking early in treatment.
- Treatment response may depend on pre-treatment drinking status.
- Further research is needed to optimize naltrexone use in diverse AUD populations.