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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EIn this article, leading alcohol researchers present the most recent findings from the COMBINE Trial, a multicenter, treatment comparison study funded by the National Institute on Alcohol and Alcohol Abuse.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESubstance-Related Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn the latest update on the COMBINE Trial, a multicenter, treatment comparison study funded by the National Institute on Alcohol and Alcohol Abuse (NIAAA), leading alcohol researchers gathered to present the most recent findings from this collaborative project.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EBriefly, the purpose of the COMBINE Trial has been to evaluate the effectiveness of behavioral management techniques, pharmacological interventions, and combinations of the two methods in the treatment of alcoholism. The rationale for which was the mounting evidence suggesting that these modes of treatment may actually enhance one another, thus, decreasing the likelihood of relapse in the recovering alcoholic. The behavioral treatment conditions included Medical Management Therapy (a brief motivational-based treatment), Combined Behavioral Intervention (CBI; a combination of Cognitive Behavioral Therapy, Motivational Enhancement Therapy and Twelve-Step Facilitation) plus Medical Management Therapy, as well as CBI alone. The drugs evaluated alone or in combination with these therapies were naltrexone and acamprosate. Treatment lasted for 16 weeks. The primary outcome measures utilized were \u201cpercent days abstinent\u201d and \u201ctime to relapse\u201d.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003ESummarizing the latest findings (Anton et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2007; 297:2003\u20132017), Robert Swift, MD, PhD, Brown University, not only noted small attrition rates, but indicated that, in the context of abstinence, most participants did well independent of the particular treatment condition to which they were randomly assigned. In fact, Dr. Swift noted a 45% mean increase in days abstinent over the course of the trial. Looking at the particular treatments, there appeared to be no significant difference in days abstinent between those patients who were on either acamprosate or naltrexone versus placebo. For \u201ctime to relapse\u201d, patients on naltrexone fared better than those taking acamprosate or placebo. In the context of therapy, no benefit was apparent in participants undergoing CBI plus Medical Management Therapy versus Medical Management Therapy alone. When looking at the particular combination of treatments, no benefit was reported in those groups taking naltrexone in combination with acamprosate, or undergoing CBI while taking acamprosate. There was however, an increase in percent days abstinent in those patients taking naltrexone in combination with Medical Management Therapy only. Dr. Swift notes, these patients \u201cdid the best\u201d, although the treatment effects were modest.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAllen Zweben, PhD, Columbia University, noted that treatment effects seen in the COMBINE trial could not be accounted for strictly based on treatment adherence rates, though 12-step program participation was higher with patients undergoing Medical Management Therapy. Still, patients taking acamprosate showed lower adherence rates than those individuals taking naltrexone only.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EOverall, the Director of NIAAA\u0027s Treatment and Recovery Research unit, Mark Willenbring, MD, was encouraged by the latest round of findings. Medical Management Therapy in conjunction with naltrexone is has shown to be an effective practice when treating individuals with alcohol problems. The clinical utility of this mode of treatment is that it is more accessible than traditional mental health service to many individuals. It can not only be used by the mental health professional, but the general practitioner as well. NIAAA has now published a step-by-step guide for the general practitioner to treat alcoholics using Medical Management Therapy. This guide is available on their website at \u003Ca href=\u0022http:\/\/www.niaaa.nih.gov\u0022\u003Ewww.niaaa.nih.gov\u003C\/a\u003E.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2007 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/7\/2\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmagq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}