Opioid antagonists in the treatment of alcohol dependence

Abstract

This article reviews the use of opioid antagonists in the pharmacologic treatment of alcohol dependence. The rationale for using the opioid antagonists naltrexone and nalmefene to prevent relapse in alcohol-dependent subjects is discussed by reviewing past and current clinical trials. The role of psychotherapies, particularly coping skills therapy, in combination with opioid antagonists is highlighted in the presentations of the clinical data. Finally, future research directions for opioid antagonists are discussed.

The role of the opioid system in alcohol dependence

“…In the last 20 years, opioid modulators have emerged as alternative treatments for alcohol dependence, and include agents that have been approved for clinical use such as naloxone, naltrexone and nalmefene (Mark et al, 2009; O’Leary et al, 2001, Oswald and Wand, 2004), alongside potential emerging agents/tools that are still at the preclinical stage, including β-funaltrexamine, CTOP, ICI 174864, naltrindole and naltriben (Herz, 1997; Hyytia and Sinclair, 1993; Krishnan-Sarin et al, 1995a, 1995b, 1998).…”

Medication-Assisted Treatment for Substance use Disorders within a National Community Health Center Research Network

“…39,45,46 Naltrexone, a nonselective opioid antagonist, can treat both alcohol and opioid dependence. [47][48][49][50][51] This medication helps patients with AUDs by decreasing cravings, reducing the urge for binge drinking during relapse, and supporting patients working towards abstinence. 52,53 Two additional medications for treating AUDs are acamprosate and disulfiram.…”

Effect of Naltrexone Administration on Short-Term Memory in Chronically Ethanol-Treated Outbred Rats

“…In the past decade there has been increasing interest in the use of pharmacotherapy to improve the effectiveness of alcoholism treatment (Kranzler, 2000;Anton, 2001;O'Leary et al, 2001;Rosenberg et al, 2002). One of the most effective drugs for the treatment of alcohol dependence seems to be naltrexone, a non-selective opioid antagonist, which decreases the likelihood of relapse into heavy drinking, most likely through a reduction of craving and/or the reinforcing effects of ethanol, although the mechanisms underlying its efficacy have not yet been satisfactorily explained (Johnson and Ait-Daoud, 2000;Sinclair, 2001).…”