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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2008.07.001 Byline: Sandra Lapham (a), Robert Forman (b), Mark Alexander (b), Ari Illeperuma (b), Michael J. Bohn (c) Keywords: Abstinence; Alcohol; Alcohol dependent; Extended-release naltrexone; Holiday drinking Abstract: A post hoc analysis examined the effect of extended-release naltrexone (XR-NTX) treatment combined with psychosocial support on alcohol consumption during holiday and nonholiday periods in a cohort of alcohol-dependent patients who had maintained at least 4 days of continuous abstinence before receiving their first treatment. Three parameters of drinking behavior were examined: percentage of drinking days, percentage of heavy drinking days, and the number of drinks per day. Patients receiving XR-NTX 380 mg reported significantly lower median percentages of drinking days, heavy drinking days, and the number of drinks per day compared with the placebo group. Patients treated with XR-NTX 190 mg reported similar results overall. The results suggest that treatment with XR-NTX 380 mg in combination with psychosocial intervention leads to significant reductions in alcohol consumption, with some measures indicating abstinence in alcohol-dependent patients with initial abstinence during holiday periods. Author Affiliation: (a) Behavioral Health Research Center of the Southwest, a Center of the Pacific Institute for Research and Evaluation, Albuquerque, NM 87110, USA (b) Alkermes, Inc., Cambridge, MA 02139, USA (c) Aurora Psychiatric Hospital, Wauwatosa, WI 53213, USA Article History: Received 5 May 2008; Revised 11 July 2008; Accepted 14 July 2008

The feasibility of using naltrexone to treat early alcohol dependence is examined. Several respondents received four sessions of brief counselling to reduce drinking during a six-week study period. Results show significant reduction drinking from pretreatment levels. The large reduction in heavy drinking is consistent with the results of controlled trials of naltrexone in alcoholics. A placebo-controlled study on the targeted naltrexone is needed to determine the optimal treatment strategy for early problem drinkers.

An evaluation of the Alcohol Use Disorders Identification Test's (AUDIT) validity revealed that the AUDIT Core Instrument is a useful tool for detecting harmful or hazardous drinking and that the AUDIT Clinical Instrument can best be used for identifying or confirming alcohol dependence. The Audit Core proved superior to the Audit Clinical and MAST tests for discriminating between hazardous and nonhazardous drinkers.