POST TREATMENT EFFECTS OF NALTREXONE

申请者摘要：申请者的长期研究目标 研究人员是为了最大限度地发挥临床治疗效果 酗酒。该方案的具体目标是比较3个月和6个月 纳曲酮(NTX)作为两种不同范围的心理治疗的辅助 和强度。这些治疗的效果将与患者一起评估。 在他们的心理社会需求和心理社会资源方面存在差异 以及他们对酒精的渴求程度。 在这项随机临床试验中，每天服用50毫克NTX或 增强治疗(MET)，或更全面的广谱 治疗(BST)，将在12周内提供(第一阶段)。在第一阶段之后， 在两种心理治疗条件下接受NTX治疗的小组中有一半将 以双盲方式交叉使用安慰剂。日常用药将继续进行 再延长3个月(第二阶段)。MET将在第一阶段终止，而 具有较大心理社会需求和较少心理社会资源的患者 可能会在第二阶段继续在BST。药物和BST在结束时终止 第二阶段，然后患者被跟踪12个月(第三阶段)。 所有治疗阶段的结果衡量标准包括：1)饮酒结果 (首次饮酒时间；戒酒天数百分比；重度饮酒天数百分比)；2)阴性 饮酒后果；3)心理社会适应。 总体而言，预计最佳治疗方案将是 针对患者的大多数独特的心理社会需求，同时 通过有效的方法解决酒精依赖的生物学问题 药物管理。

APPLICANT'S ABSTRACT: The long-term research goal of the applicant investigators is to maximize the clinical effectiveness of treatment for alcoholism. The specific aims of this protocol are to compare 3 and 6 months of naltrexone (NTX) as an adjunct to two psychotherapies that differ in scope and intensity. The effect of these treatments will be assessed with patients who differ in their psychosocial need and psychosocial resources at their disposal, and in their level of cravings for alcohol. In this randomized clinical trial, 50 mg of NTX daily and either Motivational Enhancement Treatment (MET), or the more comprehensive Broad Spectrum Treatment (BST), will be provided over 12 weeks (Phase I). Following Phase I, half of the group receiving NTX in both psychotherapy conditions will crossover to placebo, in double-blind fashion. Daily medication will continue for an additional 3 months (Phase II). MET will terminate in Phase I, while those patients with greater psychosocial need and fewer psychosocial resources may continue in BST during Phase II. Medication and BST terminate at the end of Phase II, and patients are then followed for 12 months (Phase III). Outcome measures during all treatment phases include: 1) drinking outcomes (time to first drink; % days abstinent; % heavy drinking days); 2) negative drinking consequences; and 3) psychosocial adjustment. Overall, it is anticipated that the optimum treatment package will be one that targets the majority of the unique psychosocial needs of the patient while addressing the biological aspects of alcohol dependence via effective medication management.