Naltrexone is effective for Alaska Natives and other Alaskans living in rural areas

Access to treatment for alcohol dependence (AD) in rural and remote areas is limited. This study evaluated the effectiveness of two pharmacotherapies for AD – naltrexone alone, and in combination with sertraline – among Alaska Natives (ANs) and other Alaskans living in rural settings. Findings indicate that naltrexone is just as effective on its own as it is in combination with sertraline.

Results will be published in the July issue of Alcoholism: Clinical & Experimental Research and are currently available at OnlineEarly.

“In 1994, naltrexone was the first medication to be approved by the Food and Drug Administration for the treatment of AD,” said Stephanie S. O’Malley, professor of psychiatry at Yale University School of Medicine and first author of the study. “Since then, numerous studies have shown its effectiveness. However, almost all of these studies were completed in urban settings in academically oriented clinics, and few if any Alaska Natives or American Indians were enrolled in these studies. In addition, it became clear that not all individuals benefit from naltrexone. For this reason, researchers have been investigating if different medications can be combined with naltrexone to increase its effectiveness.”

Given that previous rodent research had suggested that sertraline could potentially reduce the likelihood of drinking in response to stress, and that naltrexone was known to reduce the amount consumed if someone lapsed, the study authors thought a combination of the two might increase abstinence rates more than using naltrexone alone.

Participants in this randomized, controlled study comprised 101 Alaskans with AD: 68 American Indians (AIs) and/or ANs, and 33 non-AIs/ANs. All received one of three 16-week treatments: naltrexone + sertraline placebo, naltrexone monotherapy (50 mg) + sertraline placebo, or naltrexone + sertraline (100 mg). All three treatments included nine sessions of medical management and supportive advice.