Drug helps alcoholics without intensive counseling

The study, which is published in The Journal of the American Medical Association, found that alcoholics who took the drug naltrexone and met occasionally with a doctor or nurse fared as well as alcoholics who did both and had up to 20 psychotherapy sessions.

This could substantially improve access to treatment," says Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism, which financed the study.

Probably less than 10% of those dependent on alcohol ever enter a treatment program, Willenbring says. Some can't afford it, "and others, that's just not what they want to do," so "this is a serious disorder that's not getting adequately treated."

The study randomly divided 1,383 alcohol-dependent volunteers who recently had quit drinking into nine groups. Eight groups met with a doctor or nurse nine times over four months to discuss the ramifications of drinking, abstinence and treatment. Willenbring compared the medical management of alcoholism to that of starting a diabetic on insulin.

The eight groups received either naltrexone, which costs $4 or $5 a day; acamprosate, a newer drug sold as Campral; both drugs; or two placebo pills. Four of those groups also received psychotherapy sessions. A ninth group received only psychotherapy.

All groups significantly reduced their drinking by the time treatment ended. The most effective: either naltrexone or psychotherapy. But a year later, the differences between groups were no longer statistically significant, suggesting that treatment longer than four months may be necessary, Willenbring said.

Overall, Campral, with or without psychotherapy, was no more effective than a placebo. In an accompanying editorial, the University of Connecticut's Henry Kranzler called that "perplexing," given previous research.

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