Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence

Anton, Raymond F.; O’Malley, Stephanie S.; Ciraulo, Domenic A.; Cisler, Ron A.; Couper, David J.; Donovan, Dennis M.; Gastfriend, David R.; Hosking, James D.; Johnson, Bankole A.; LoCastro, Joseph S.; Longabaugh, Richard; Mason, Barbara J.; Mattson, Margaret E.; Miller, William R.; Pettinati, Helen M.; Randall, Carrie L.; Swift, Robert M.; Weiss, Roger D.; Williams, Lauren D.; Zweben, Allen

doi:10.1001/jama.295.17.2003

Cited by 1,736 publications

(1,549 citation statements)

References 56 publications

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“…(2) Do clinically utilized doses of naltrexone alter marijuana's intoxicating effects in patients seeking drug treatment? Naltrexone is used to treat both alcohol and opioid dependence (Anton et al, 2006;Gonzales et al, 2002), and the standard clinical doses are 50-150 mg. The present results in combination with our earlier report (Haney et al, 2003) suggest that marijuana-smoking patients treated with high naltrexone doses may experience an enhanced effect from marijuana.…”

Section: Future Studiesmentioning

confidence: 99%

Opioid Antagonism of Cannabinoid Effects: Differences between Marijuana Smokers and Nonmarijuana Smokers

Haney

2006

Neuropsychopharmacol

102

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In non-human animals, opioid antagonists block the reinforcing and discriminative-stimulus effects of D 9 -tetrahydrocannabinol (THC), while in human marijuana smokers, naltrexone (50 mg) enhances the reinforcing and subjective effects of THC. The objective of this study was to test a lower, more opioid-selective dose of naltrexone (12 mg) in combination with THC. The influence of marijuana-use history and sex was also investigated. Naltrexone (0, 12 mg) was administered 30 min before oral THC (0-40 mg) or methadone (0-10 mg) capsules, and subjective effects, task performance, pupillary diameter, and cardiovascular parameters were assessed in marijuana smoking (Study 1; n ¼ 22) and in nonmarijuana smoking (Study 2; n ¼ 21) men and women. The results show that in marijuana smokers, low-dose naltrexone blunted the intoxicating effects of a low THC dose (20 mg), while increasing ratings of anxiety at a higher THC dose (40 mg). In nonmarijuana smokers, low-dose naltrexone shifted THC's effects in the opposite direction, enhancing the intoxicating effects of a low THC dose (2.5 mg) and decreasing anxiety ratings following a high dose of THC (10 mg). There were no sex differences in these interactions, although among nonmarijuana smokers, men were more sensitive to the effects of THC alone than women. To conclude, a low, opioid-selective dose of naltrexone blunted THC intoxication in marijuana smokers, while in nonmarijuana smokers, naltrexone enhanced THC intoxication. These data demonstrate that the interaction between opioid antagonists and cannabinoid agonists varies as a function of marijuana use history.

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Section: Future Studiesmentioning

confidence: 99%

Opioid Antagonism of Cannabinoid Effects: Differences between Marijuana Smokers and Nonmarijuana Smokers

Haney

2006

Neuropsychopharmacol

102

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“…This allows individuals at various stages of change (Prochaska & DiClemente, 1982) to investigate treatment options, without experiencing shame or guilt that may be associated with disclosing the presence of a disorder, missing assessment sessions or dropping out of therapy. Third, there is support for the effective use of cognitive-behavioral therapy (CBT) and motivational interviewing (MI) interventions in the treatment of addictions including drug and alcohol abuse and dependence and problem gambling (Anton et al, 2006;Carlbring, Jonsson, Josephson, & Forsberg, 2009;Carroll et al, 2006;Martins & McNeil, 2009;MTP Research Group. 2004).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of Internet-based therapy for the treatment of addictions

Gainsbury

Blaszczynski

2011

Clinical Psychology Review

170

135

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“…The chronic nature of substance use disorders (SUD) seen in alcohol and drug treatment settings 6, 7 continues to present challenges to clinicians and researchers. Identifying consistent predictors of chronic SUDs in prospective studies has been difficult.…”

Section: Introductionmentioning

confidence: 99%

Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders

Hasin

Fenton

Skodol

et al. 2011

Arch Gen Psychiatry

183

100

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Context Little is known about the role of a broad range of personality disorders in the course of substance use disorder (SUD), and whether these differ by substance. The existing literature focuses mostly on antisocial personality disorder and does not come to clear conclusions. Objective To determine the association between the ten DSM-IV personality disorders and the persistence of common SUDs in a 3-year prospective study of a national sample. Design Data were drawn from participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had alcohol dependence (N=1,172), cannabis use disorder (N=454) or nicotine dependence (N=4,017) at baseline and who were re-interviewed three years later. Control variables included demographic characteristics, family history of substance disorders, baseline Axis I disorders and treatment status, and prior SUD duration. Main outcome measure Persistent SUD, defined as meeting full criteria for the relevant SUD throughout the 3-year follow-up period. Results Persistent SUD was found among 30.1% of participants with alcohol dependence, 30.8% with cannabis use disorder, and 56.6% with nicotine dependence at baseline. Axis I disorders did not have strong or consistent associations with persistent SUD. In contrast, antisocial personality disorder was significantly associated with persistent alcohol, cannabis and nicotine use disorders (adjusted odds ratios: 2.46-3.51), as was borderline personality disorder (adjusted odds ratios: 2.04-2.78) and schizotypal personality disorder (adjusted odds ratios: 1.65-5.90). Narcissistic, schizoid, and obsessive-compulsive personality disorders were less consistently associated with SUD persistence. Conclusions The consistent findings on the association of antisocial, borderline and schizotypal personality disorders with persistent SUD indicates the importance of these personality disorders in understanding the course of SUD. Future studies should examine dimensional representations of personality disorders and the role of specific components of these disorders, biological and environmental contributors to these relationships, and potential applications of these findings to treatment development.

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Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence

Abstract: clinicaltrials.gov Identifier: NCT00006206.

Cited by 1,736 publications

References 56 publications

Opioid Antagonism of Cannabinoid Effects: Differences between Marijuana Smokers and Nonmarijuana Smokers

Opioid Antagonism of Cannabinoid Effects: Differences between Marijuana Smokers and Nonmarijuana Smokers

A systematic review of Internet-based therapy for the treatment of addictions

Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders

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