Adoption of naltrexone to treat alcohol dependence

Fuller, Bret E.; Rieckmann, Traci; McCarty, Dennis; Smith, Kevin; Levine, Helen

doi:10.1016/j.jsat.2005.02.003

Cited by 52 publications

(67 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Taking fewer pills than prescribed for the full treatment period has also been consistently reported in alcohol dependent populations for both disulfiram (Fuller, Rieckmann, McCarty, Smith et al, 2005) and naltrexone Volpicelli, Rhines, Rhines, Volpicelli et al, 1997). While typically disulfiram has had much higher nonadherence problems than naltrexone (De Witte et al, 2005;Fuller & Gordis, 2004;Suh et al, 2006), in this study, the medication adherence rates for patients taking 80% of their medications while in treatment were found to be similar for the two medications, although there was a nonsignificant difference that indicated patients overall ingested more naltrexone than disulfiram (medication exposure rates).…”

Section: Discussionmentioning

confidence: 84%

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

Pettinati

Kampman

Lynch

et al. 2008

Addictive Behaviors

View full text Add to dashboard Cite

BACKGROUND-This is a double blind, placebo-controlled trial that evaluated the efficacy of disulfiram, naltrexone and their combination in patients with co-occurring cocaine and alcohol dependence.METHODS-208 patients were randomized to disulfiram (250mg/day), naltrexone (100mg/day), the combination, or placebo for 11 weeks. Outcomes were in-trial abstinence from cocaine and/or alcohol.RESULTS-Few safety concerns were reported, although medication adherence was low in a number of patients for both medications, alone or in combination. In the primary analyses (GEE modeling), abstinence from cocaine as measured by cocaine-negative urines and days of self-reported abstinence from cocaine or alcohol did not differ between placebo and any of the medication groups. However, patients taking disulfiram (alone or in combination) were most likely to achieve combined abstinence from cocaine and alcohol. Secondary analyses revealed that patients taking the disulfiramnaltrexone combination were most likely to achieve 3 consecutive weeks of abstinence from cocaine and alcohol.CONCLUSION-There was an association between disulfiram treatment and abstinence from cocaine and alcohol. More patients taking the disulfiram-naltrexone combination achieved 3 consecutive weeks of abstinence in treatment than placebo-treated patients.

show abstract

Section: Discussionmentioning

confidence: 84%

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

Pettinati

Kampman

Lynch

et al. 2008

Addictive Behaviors

View full text Add to dashboard Cite

show abstract

“…Although effective and promising substance abuse treatment medications have been developed and are available in the US (Anton, 2001), there is ample evidence that the rate of adoption of these medications by American treatment organizations has been slow . Addressing this "research to practice gap" requires an understanding of the organizational characteristics that facilitate and deter the adoption of substance abuse treatment medications by providers (Fuller et al, 2005;Simpson, 2002).…”

Section: Introductionmentioning

confidence: 99%

“…The emergent literature on medication adoption has been limited to regional samples (Fuller et al, 2005), private sector facilities (Knudsen et al, 2005;Roman and Johnson, 2002), and the practices of individual physicians (Mark et al, 2003a;Mark et al, 2003b). Understanding the role of treatment organizations is critical because recent research has revealed that the organizational context dramatically affects the prescribing behaviors of physicians and the likelihood that counselors will encourage and/or support the use of medications by their clients (Thomas et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

The adoption of medications in substance abuse treatment: Associations with organizational characteristics and technology clusters

Knudsen

Ducharme

Roman

2007

Drug and Alcohol Dependence

124

View full text Add to dashboard Cite

Despite growing interest in closing the "research to practice gap," there are few data on the availability of medications in American substance abuse treatment settings. Recent research suggests that organizational characteristics may be associated with medication availability. It is unclear if the availability of medications can be conceptualized in terms of "technology clusters," where the availability of a medication is positively associated with the likelihood that other medications are also offered. Using data from 403 privately funded and 363 publicly funded specialty substance abuse treatment centers in the US, this research models the availability of agonist medications, naltrexone, disulfiram, and SSRIs. Bivariate logistic regression models indicated considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and forprofit treatment centers. Some of these differences were attenuated by organizational characteristics, such as accreditation, the presence of staff physicians, and the availability of detoxification services. There was some evidence that naltrexone, disulfiram, and SSRIs represent a group of less intensely regulated medications that is distinct from more intensely regulated medications. These types of medications were associated with somewhat different correlates. Future research should continue to investigate the similarities and differences in the predictors of medication availability across national contexts.

show abstract

“…Challenges of implementing evidence-based practices in community settings have been described (Miller, Zweben, & Johnson, 2005;Lamb, Greenlick & McCarty, 1998;Rawson, Marinelli-Casey, & Ling, 2002), and several studies have examined the relationship of organizational and workforce characteristics and the use of evidence-based practices (Fuller, Rieckmann, McCarty, Smith, & Levine, 2005;Knudsen, Roman, Ducharme, & Johnson, 2005). Further study of providers' perspectives and experiences with a variety of treatment interventions are needed, particularly in relation to program and workforce characteristics.…”

Section: Introductionmentioning

confidence: 99%

Empirically supported substance abuse treatment approaches: A survey of treatment providers' perspectives and practices

Herbeck¹,

Hser²,

Teruya³

2008

Addictive Behaviors

View full text Add to dashboard Cite

To better understand the extent that empirically supported and promising substance abuse treatment approaches are implemented in community settings, treatment providers were surveyed regarding their perceptions and use of several psychosocial and pharmacological treatment interventions. Program directors (n=30) and staff members (n=331) from diverse community settings rated the effectiveness and extent of use of various treatment interventions, and provided information on program and workforce characteristics via self-administered questionnaires. On average, program directors and staff rated the psychosocial treatment interventions as effective, with the exception of vouchers/motivational incentives. About half of the treatment providers did not know the effectiveness of certain pharmacological treatments, including buprenorphine and naltrexone. Respondents from the majority of programs (55%-80%) reported using Motivational Enhancement Therapy, Community Reinforcement Approach, and Supportive Expressive Psychotherapy. The extent that programs used several of the treatment interventions was related to organizational training and information resources. The study findings provide important information regarding training and research dissemination efforts.

show abstract

Adoption of naltrexone to treat alcohol dependence

Cited by 52 publications

References 19 publications

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

The adoption of medications in substance abuse treatment: Associations with organizational characteristics and technology clusters

Empirically supported substance abuse treatment approaches: A survey of treatment providers' perspectives and practices

Contact Info

Product

Resources

About