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Impact of Treatment With Intramuscular, Injectable, Extended-Release Naltrexone on Counseling and Support Group Participation in Patients With Alcohol Dependence

Cisler, Ron A. PhD; Silverman, Bernard L. MD; Gromov, Irina MD, PhD; Gastfriend, David R. MD

doi: 10.1097/ADM.0b013e3181c82207
Original Article

Objectives: The impact of intramuscular, injectable, extended-release naltrexone (XR-NTX; Vivitrol) on counseling and support group participation was examined in a post hoc analysis of a 24-week, randomized, double-blind study in 624 alcohol-dependent adults, most of whom were nonabstinent at baseline.

Methods: Patients were offered 6 monthly injections of XR-NTX 380 mg, XR-NTX 190 mg, or placebo (n = 205, 210, and 209, respectively) and 12 sessions of manualized brief counseling. Voluntary participation in extramural counseling (eg, couples or family therapy) and self-help support groups (eg, Alcoholics Anonymous) was permitted and assessed.

Results: The proportion of patients attending all 12 Biopsychosocial, Report, Empathy, Needs, Direct advice, and Assessment sessions was nonsignificantly greater for XR-NTX 380 mg (45%) than for placebo (39%), as was the proportion attending extramural counseling (10% vs 7%) and support groups (13% vs 10%). Attendance rates were intermediate with XR-NTX 190-mg. Attending self-help groups was significantly (P = 0.04) related to reduced heavy drinking across all treatment groups.

Conclusions: XR-NTX is compatible with counseling and support group participation in the treatment of alcohol dependence.

From the University of Wisconsin-Milwaukee (RAC), Milwaukee, WI; University of Wisconsin School of Medicine and Public Health (RAC), Madison, WI; Aurora Health Care, Inc. (RAC), Milwaukee, WI; Alkermes, Inc. (BLS, DRG), Cambridge, MA; and Matrix Alliance, Inc. (IG), Dallas, TX.

Received for publication July 15, 2008; accepted October 27, 2009.

Send correspondence and reprint requests to Ron A. Cisler, PhD, Center for Urban Population Health, Aurora Sinai Medical Center, 1020 North 12th Street, Suite 4180, Milwaukee, WI 53233. e-mail:

Supported by Alkermes, Inc., Cambridge, MA.

© 2010 American Society of Addiction Medicine