Different strategies of relapse prevention: A meta-analysis of drug efficiency

Abstract

Craving reduction in alcoholism 161s families with a high genetic loading for alcohol dependence have suggested that some may inherit an oversensitivity to this effect, and it has been suggested that this might contribute to the loss of control experienced by some drinkers [I). Opiate antagonists such as naltrexone reduce ethanol-seeking in alcohol-dependent animals. Two published double-blind randomised controlled studies in detoxified patients taking part in an outpatient treatment programme report that naltrexone 50 mg daily reduces the risk of self-reported relapse, at least for three months (2). Objective markers of alcohol consumption have helped to support this result. Results of longer studies in larger samples are awaited. Some patients who resume drinking while taking naltrexone report that they feel less of the ethanol 'high'. Perhaps they then experience less impulse to carry on drinking (2). However, studies have found an increase in the numbers of patients who report achieving total abstinence as well as a reduction of drinking overall. Naltrexone is not addictive in the sense that there is a withdrawal syndrome. it is well tolerated and it has a good safety record. Follow-up has not indicated rapid relapse on cessation of the drug. More information is needed on which patients respond, which is the optimal timing and duration of use. and which psychological and social interventions are necessary compliments. As with other treatments psychological approaches enhancing compliance will be an important factor in determining the effectiveness of opiate antagonists in routine clinical practice.

Tracking Study on the Relapse and Aftercare Effect of Drug Patients Released From a Compulsory Isolated Detoxification Center

“…On the other hand, for drug abstainers who have already used drugs, it is also very important and arduous to carry out scientific drug detoxification to cure their behavioral and mental compulsion related to chronic drug addiction-related tendencies ( 8 , 19 ) and reduce their relapse rate. Moreover, after detoxification treatment, it is difficult for drug abstainers to eliminate the effects of drugs on their psychology, physiology and social life, and they find it difficult to cope with high-risk situations involving drugs and achieve true “detoxification,” resulting in reuse of drugs ( 20 ).…”