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- Title
Treatment of cocaine-alcohol dependence with naltrexone and relapse prevention therapy.
- Authors
Schmitz, Joy M.; Stotts, Angela L.; Sayre, Shelly L.; DeLaune, Katherine A.; Grabowski, John
- Abstract
This study evaluates whether patients with cocaine-alcohol dependence might benefit from naltrexone (NTX) pharmacotherapy when delivered in conjunction with psychotherapy. Eighty outpatients meeting DSM-IV criteria for alcohol and cocaine dependence were randomly assigned to receive NTX (placebo or 50 mg/d) combined with psychotherapy (Relapse Prevention [RP] or Drug Counseling [DC]) for twelve weeks. It was hypothesized that the skills training focus of RP therapy, in combination with NTX 50 mg/d, would produce greater reductions in cocaine and alcohol use. Outcome measures included self- and objective reports of substance use, treatment retention, medication compliance, and adverse effects. During the first four weeks of treatment, the percentage of cocaine-positive urine screens was significantly lower for those receiving RP therapy (22%) than those receiving DC (47%); however, this difference subsequently diminished. No medication effects were found. All groups reported less alcohol use at the end of treatment. Treatment retention was the same among the groups, with about 33% of the subjects completing all twelve weeks of treatment. The active medication group showed better medication compliance, while the number of adverse events was low overall and not significantly different by group. In conclusion, NTX at 50 mg/d did not reduce cocaine or alcohol use. These findings stand in contrast to previously reported positive findings for NTX and RP in patients with a single diagnosis of cocaine dependence.
- Subjects
NALTREXONE; COCAINE abuse treatment; ALCOHOLISM treatment; DRUG therapy; PSYCHOTHERAPY; URINALYSIS; THERAPEUTICS; REHABILITATION of people with alcoholism; SUBSTANCE abuse treatment; DISEASE relapse prevention; NARCOTIC antagonists; ALCOHOLISM; CLINICAL trials; COGNITIVE therapy; COMBINED modality therapy; COMPARATIVE studies; COUNSELING; RESEARCH methodology; MEDICAL cooperation; PATIENT compliance; RESEARCH; SUBSTANCE abuse; COMORBIDITY; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness
- Publication
American Journal on Addictions, 2004, Vol 13, Issue 4, p333
- ISSN
1055-0496
- Publication type
journal article
- DOI
10.1080/10550490490480982