Naltrexone in the treatment of alcoholism.: Two-year follow up results

Aims: The usefulness of opioid antagonists in the treatment of alcoholism has been suggested both in the experimental and in the clinical field: Design: Randomized clinical trial. Methods: 30 patients who met the criteria for alcohol dependency or abuse (DSM IV), and who had undergone 3 or more aversion treatments in the last three pears were included. The patients were randomly distributed into two groups. The first group (NTX) (n=15) received a pharmacological treatment in the form of an aversion treatment for one year plus 25 mg of Naltrexone daily during the first 6 months; the second group was used as a Control, receiving aversion treatment daily for 12 months. Afterwards follow up controls were carried out with regard to the degree of abstinence/relapse after 12, 18, and 24 months. Results: The data are analyzed by means of a survival analysis (during the first 6 months) and a risk estimate (in the subsequent temporal controls). The probability of remaining abstinent during the first six months is greater in the NTX group than in the control group (p = 0.0244). One year after initiating the study/program, 73.3% of the NTX group subjects and 20% of the control group subjects remained abstinent (RR = 0.21; CI95% 0.06 to 0.81); after 2 years 40% of the experimental subjects remained abstinent, versus none of the controls (RR = 0.50; CI95% 0.28 to 0.88). Conclusion: We believe that the combined treatment of aversion and NTX would be effective in patients with multiple relapses, who are refractory to treatment; patients in whom the classic aversion treatment has shown to have a limited efficacy.