TY - JOUR
T1 - Cigarette smoking predicts differential benefit from naltrexone for alcohol dependence
AU - Fucito, Lisa M.
AU - Park, Aesoon
AU - Gulliver, Suzy Bird
AU - Mattson, Margaret E.
AU - Gueorguieva, Ralitza V.
AU - O'Malley, Stephanie S.
N1 - Funding Information:
We acknowledge that the reported results are, in whole or in part, based on analyses of the COMBINE Data Set. These data were collected as part of a multisite clinical trial of alcoholism treatments supported by a series of grants from the National Institute on Alcohol Abuse and Alcoholism , National Institutes of Health , Department of Health and Human Services . This report has not been reviewed or endorsed by National Institute on Alcohol Abuse and Alcoholism or the COMBINE Research Group and does not necessarily represent the opinions of its members or National Institute on Alcohol Abuse and Alcoholism, who are not responsible for the contents.
Funding Information:
This research was supported in part by grants from the National Institute on Alcohol Abuse and Alcoholism : K05-AA014715 (SSO), R01-AA016621 (SSO, RG), K23-AA02000 (LMF), and T32-AA015496 (LMF).
PY - 2012/11/15
Y1 - 2012/11/15
N2 - Background: Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism. Methods: We examined the association between cigarette smoking and drinking outcomes in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management, combined behavioral therapy) in 1383 alcohol-dependent individuals. Results: Smokers (i.e., more than one half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received combined behavioral intervention or medical management and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking, and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment. Conclusions: These results suggest that naltrexone might be particularly beneficial for improving alcohol use outcomes in alcohol-dependent smokers.
AB - Background: Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism. Methods: We examined the association between cigarette smoking and drinking outcomes in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management, combined behavioral therapy) in 1383 alcohol-dependent individuals. Results: Smokers (i.e., more than one half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received combined behavioral intervention or medical management and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking, and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment. Conclusions: These results suggest that naltrexone might be particularly beneficial for improving alcohol use outcomes in alcohol-dependent smokers.
KW - Acamprosate
KW - alcohol dependence
KW - behavioral treatment
KW - cigarette smoking
KW - naltrexone
KW - pharmacotherapy
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U2 - 10.1016/j.biopsych.2012.03.023
DO - 10.1016/j.biopsych.2012.03.023
M3 - Article
C2 - 22541040
AN - SCOPUS:84867748661
SN - 0006-3223
VL - 72
SP - 832
EP - 838
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 10
ER -