Opioid antagonists can decrease alcohol consumption in animals. The review findings support that short-term treatment of naltrexone (NTX) decreases the chance of alcohol relapses for 36% and likely to reduce the chance of returning to drinking for 13%. NTX treatment can lower the risk of treatment withdrawal in alcohol-dependent patients for 28% (NNT = 13). The evidence so far have supported that NTX should be accepted as a short-term treatment for alcoholism. Strategies to improve adherence to NTX treatment, e.g., psychosocial interventions and management of adverse effects, should be concomitantly given. We have not yet known so far how long alcohol-dependent patients who respond to NTX treatment should continue their treatment. Nalmefene has too little evidence to support its clinical use.
"Naltrexone is not as widely used in the treatment of opiate dependence as methadone and buprenorphine, although it has a more favorable safety profile, no addictive liability, and diminished stigma since it is not a replacement therapy (Mason, 2003; Ross & Peselow, 2009). Although results have been mixed in regard to the effectiveness of naltrexone in the treatment of opiate dependence, it has been shown to reduce alcohol consumption, the rewarding effects of alcohol, craving for alcohol, and rates of relapse (Kranzler & Van Kirk, 2001; Rosner et al., 2010b; Srisurapanont, & Jarusuraisin, 2005). However, poor adherence is common and is associated with higher relapse rates (Pettinati, Volpicelli, Pierce, & O'Brien, 2000; Ross & Peselow, 2009). "
[Show abstract][Hide abstract] ABSTRACT: Data from a national study of 345 privately funded, community-based substance use disorder (SUD) treatment centers were used to investigate social workers' knowledge, perceptions of effectiveness, and perceptions of the acceptability of medication assisted treatments (MATs) for SUDs. Results reveal the importance of exposure to MATs for social workers to develop a knowledge base regarding the effectiveness of various pharmacological agents. Results also underline the importance of social workers' perceptions of effectiveness in forming opinions regarding the acceptability of the use of MATs in SUD treatment. Lastly, a 12-Step orientation toward treatment has a negative influence on social workers' opinions regarding the acceptability of MATs.
Social Work in Health Care 01/2013; 52(1):43-58. DOI:10.1080/00981389.2012.725457 · 0.62 Impact Factor
"Cocaine immunotherapy (popularly called a cocaine “vaccine”) to prevent cocaine molecules from entering the brain is now in development, but previews do not look promising for wide-scale use (96). Other types of medications include blocking agents, such as naltrexone for opiate addiction, which occupy neuronal receptors and blunt a drug’s effect (97). Aversive agents, such as Antabuse (disulfiram), cause people to feel nauseated and vomit when they ingest alcohol (98). "
"In clinical trials, naltrexone reduced the percentage of heavy drinking days (Pettinati et al. 2006). Recent meta-analyses have indicated that oral naltrexone has modest efficacy over 3 months on preventing relapse to heavy drinking, return to any drinking, and medication discontinuation (Srisurapanont et al. 2005). The standard dose is 50 mg daily, but a multisite study demonstrated that 100 mg daily also was effective when combined with medical management (Anton et al. 2006). "
[Show abstract][Hide abstract] ABSTRACT: The prevalence of unidentified or untreated unhealthy alcohol use remains high. With the advent of pharmacotherapy and models of counseling appropriate for use in primary care settings as well as in specialty care, clinicians have new tools to manage the range of alcohol problems across the spectrum of health care settings. By extending treatment to primary care, many people who do not currently receive specialty care may have increased access to treatment. In addition, primary care providers, by virtue of their ongoing relationship with patients, may be able to provide continuing treatment over time. Extending the spectrum of care to hazardous drinkers who may not be alcohol dependent could result in earlier intervention and reduce the consequences of excessive drinking.
Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism 03/2011; 33(4):300-12. · 0.58 Impact Factor
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