Objective
This study tested the comparative effectiveness of Modified Behavioral Self-Control Therapy (MBSCT) and naltrexone (NTX), as well as the added benefit of combining the two, in problem drinking men who have sex with men (MSM) seeking to reduce, but not quit drinking. Method: Participants (N=200) were recruited and urn randomized to one of two medication conditions, NTX or placebo (PBO) and either MSBCT or no behavioral intervention, yielding four conditions: PBO, NTX, MSBCT, and NTX+MSBCT. In addition, all participants received a brief medication compliance intervention. Participants were treated for 12 weeks and assessed one week after treatment completion. Two primary outcomes - sum of standard drinks and number of heavy drinking days - and one secondary outcome - percentage of those drinking in a non-hazardous manner (NoH) - were selected a-priori. Results: There was a significant main effect for MBSCT (all ps < .01), but not NTX on all three outcomes. In addition, the combination of NTX and MBSCT was not more effective than either MSCBT or PBO. There was a significant interaction effect on NoH, such that NTX significantly increased the likelihood (OR = 3.3) of achieving a non-hazardous drinking outcome relative to PBO. In addition, NTX was significantly more effective than PBO on a descriptive outcome: negative consequences of drinking.
Conclusions
There was no advantage to adding NTX to MBSCT. In addition, MBSCT showed stronger evidence of efficacy than NTX. At the same time, NTX delivered in the context of a minimal medication compliance intervention was significantly more effective than PBO on an important clinical indicator. Results provide new information to guide the treatment of problem drinking, including in primary care settings.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.