MEDICAL-MANAGEMENT OF ALCOHOL DEPENDENCE - CLINICAL USE AND LIMITATIONS OF NALTREXONE TREATMENT

Citation
Jr. Volpicelli et al., MEDICAL-MANAGEMENT OF ALCOHOL DEPENDENCE - CLINICAL USE AND LIMITATIONS OF NALTREXONE TREATMENT, Alcohol and alcoholism, 30(6), 1995, pp. 789-798
Citations number
42
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Substance Abuse
Journal title
ISSN journal
0735-0414
Volume
30
Issue
6
Year of publication
1995
Pages
789 - 798
Database
ISI
SICI code
0735-0414(1995)30:6<789:MOAD-C>2.0.ZU;2-Q
Abstract
Historically, pharmacological and psychosocial treatments for alcohol dependence have demonstrated only modest effectiveness in reducing alc ohol drinking. However, the recent US Food and Drug Administration app roval of naltrexone for the treatment of alcohol dependence offers a n ew, safe and effective medication to reduce relapse following alcohol detoxification. This paper reviews the various psychosocial and pharma cological treatments currently available and the effectiveness of thes e treatments. This paper also reviews preclinical research which demon strates the involvement of the opioid system in the reinforcing effect s of alcohol. This research led to clinical trials on the use of the o pioid antagonist, naltrexone, to reduce alcohol's pleasurable effects and enhance the effectiveness of psychosocial therapy. In two randomiz ed clinical trials, naltrexone treatment reduced rates of alcohol rela pse, number of drinking days and alcohol craving. The clinical efficac y of all pharmacological treatments for substance abuse are limited by compliance with taking the medication. Also, pharmacological treatmen t does not address the psychosocial complications which often result f rom chronic alcohol dependence. Therefore, the integration of medicati ons such as naltrexone and psychosocial therapies may offer the best t reatment. The further development and investigation of new pharmacolog ical agents will enable matching of patient populations with specific treatments, offering more successful treatment outcomes.