Pharmacotherapy for alcohol dependence is always delivered in a psychosocial context that may affect the outcome of the treatment. The rigorous study of different psychotherapeutic treatments for alcohol dependence has shown several distinct approaches to be effective. This article reviews the combination of alcohol dependence pharmacotherapies, including disulfiram, naltrexone, and acamprosate, with different psychosocial interventions. Many psychosocial interventions for alcohol dependence, including Alcoholics Anonymous, can be integrated successfully with pharmacotherapy. Psychosocial interventions, ranging from brief medical management to more intensive manualized psychotherapies, have all been shown to produce positive outcomes in certain studies, depending on the specific medication and the study context. Particularly successful combinations may include the use of behavioral marital therapy plus a disulfiram contract for patients taking that medication, and the combination of naltrexone or acamprosate with cognitive-behavioral therapy or psychosocial support. Ongoing research examining the optimal combinations of medications with different psychosocial treatments for alcohol dependence may further inform the field.
*Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA †Department of Psychiatry, Harvard Medical School, Boston, MA and ‡Central Street Health Center, Outpatient Addiction Service, Somerville, MA.
Received August 17, 2006; accepted after revision September 28, 2006.
Supported by the National Institute on Drug Abuse grant K02 DA00326 (R.D.W.).
Address correspondence and reprint requests to Roger D. Weiss, MD, McLean Hospital, 115 Mill St, Belmont, MA 02478. E-mail: email@example.com.