Naltrexone treatment of comorbid alcohol and cocaine use disorders

• Published in: Psychopharmacology Vol. 139; no. 1-2; pp. 44 - 52
• Main Authors: Hersh, D, Van Kirk, J R, Kranzler, H R
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.09.1998
• Subjects: Adult; Alcohol; Alcohol Deterrents - therapeutic use; Alcohol Drinking - drug therapy; Alcoholism - complications; Alcoholism - drug therapy; Clinical trials; Cocaine; Cocaine-Related Disorders - complications; Cocaine-Related Disorders - drug therapy; Comorbidity; Compliance; Dosage; Double-Blind Method; Drug dependence; Female; Humans; Male; Naltrexone; Naltrexone - therapeutic use; Placebos
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s002130050688

Naltrexone (NTX) has been shown to be efficacious for the treatment of alcohol dependence. Since alcohol and cocaine use disorders commonly co-occur, we conducted a randomized, double-blind, placebo-controlled trial of NTX 50 mg/day in 64 subjects with comorbid alcohol and cocaine use disorders. Although subjects in both groups reduced their consumption of both alcohol and cocaine during the 8-week trial, there was no consistent advantage to NTX over placebo treatment. We conclude that, due to behavioral, neurochemical, or other factors, individuals with both alcohol and cocaine use disorders are distinct from those dependent on alcohol alone, and that NTX at a dosage of 50 mg/day is not efficacious in this patient population. Several factors, including medication dosage, length of treatment, sample size and attrition rate, limit the interpretation of these findings. Consequently, we recommend that subsequent trials of NTX to reduce the risk of relapse in patients with comorbid alcohol and cocaine use disorders take these issues into account.