Cigarette Smoking Predicts Differential Benefit from Naltrexone for Alcohol Dependence
Biological Psychiatry, 05/01/2012Fucito LM et al.
The results suggest that naltrexone might be particularly beneficial for improving alcohol use outcomes in alcohol–dependent smokers.
The authors 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.
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.
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