Integrated psychosocial and opioid-antagonist treatment for alcohol dependence: A systematic review of controlled evaluations

Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist treatment had outcomes superior to those of clients receiving monotherapy (generally placebo and standard psychosocial treatment). Rates of relapse, levels of self-reported alcohol craving, and extent of posttreatment alcohol consumption were significantly reduced in clients receiving integrated therapy relative to controls. However, the long-term efficacy of integrated psychosocial and opioid-antagonist alcohol dependence treatment was not established, and client factors associated with the differential effectiveness of integrated interventions were not identified.