Naltrexone Is Effective in Treating Both Men and Women for Alcohol Dependency
Lead researcher Dr. Shelly F. Greenfield from McLean Hospital and Harvard Medical School in Massachusetts and her colleagues conducted a national, multi-site trial using the Combining Medications and Behavioral Interventions (COMBINE) for Alcohol Dependence database. The purpose of the study was to discover the presence of any differences between male and female patients after they received alcoholism treatment that involved behavioral therapy, medication, or a combination of both.
Previously, very little research had been conducted on gender differences among behavioral and pharmacological therapies in alcohol dependency treatment programs. Historically, more men suffer from alcohol use disorders than women by a large proportion, yet this gender gap has been narrowing during the past decade. Men were at once five times more likely to receive treatment for alcohol dependence than women; today, men are about twice as likely as women to seek treatment.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), females with substance abuse disorders experience more barriers that may discourage them from seeking treatment compared with their male counterparts, including stigmatization, childcare responsibilities, and lack of employment or health insurance. Female substance abusers are also more likely to have experienced traumatic events preceding their addictions, and are more vulnerable to the physiological effects of substance abuse. Because of these large disparities, female patients of recovery programs require more specialized treatment and services compared to male patients. Amid rising numbers of females seeking substance abuse treatment, the researchers sought to identify which pharmacological and behavioral treatment methods are gender-specific and which are effective for both men and women.
Between 2001 and 2004, researchers followed eight groups consisting of 848 male and 378 female patients of alcohol dependency treatment who were undergoing nine-session medical management intervention that focused on adherence to medication therapy and abstinence. The recently abstinent participants underwent 16 weeks of placebo, 100 mg of Naltrexone per day, 3 grams of Acamprosate per day, or a combination of all three while either receiving or not receiving combined behavioral intervention from a specialist. The researchers measured the overall outcome as well as gender-specific outcomes regarding the patients’ interactions with their treatment conditions.
The presence of gender disparities regarding alcohol use and treatment outreach was apparent among certain preliminary factors:
• Compared to male patients, female patients were more likely to report a later age of alcohol dependency onset by three years.
• Females were much less likely to have received previous treatment for their alcohol dependency than male patients.
• Female patients reported consuming fewer drinks per drinking day than men.
Besides these measures, male and female patients did not present any significant differences in their drinking patterns. For those who underwent COMBINE treatment, women showed the same pattern as men regarding their first heavy drinking day, number of heavy drinking days, number of days spent abstinent, and positive clinical response measures. Additionally, participants who received Naltrexone treatment reported lower craving than those who received placebo. Researchers state that these results demonstrate that Naltrexone is effective in treating both men and women.
Based on this clinical outcome, the researchers advise that clinicians should feel confident in prescribing Naltrexone to treat alcohol dependence in both their male and female patients. Furthermore, Naltrexone can be administered not just in specialty substance abuse treatment facilities but also in primary health care settings, which is where substance abusing women tend to seek treatment for their addictions more often. Despite where treatment is sought, Naltrexone in combination with medical management therapy demonstrates the same positive outcome for recovering alcohol dependent women as men. This effective method of treatment for women is pertinent for their recovery since the number of women with alcohol use disorders today is rising. Also, reaching women at such a moment of dependency is crucial to their recovery since women suffer from more health complications due to alcohol use and at a faster rate than men.
The researchers’ study was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and is available online or in the October 2010 print issue of Alcoholism: Clinical & Experimental Research.
Sources: Alcoholism: Clinical and Experimental Research, Gender Difference in Alcohol Treatment: An Analysis of Outcome from the COMBINE Study, July 20, 2010
Medical News Today, No Gender Difference In Response To Naltrexone As Treatment For Alcohol Dependence, July 21, 2010