Journal article
Targeted Opioid Receptor Antagonists in the Treatment of Alcohol Use Disorders
CNS drugs, Vol.27(10), pp.777-787
10/2013
DOI: 10.1007/s40263-013-0096-4
PMCID: PMC4600601
PMID: 23881605
Abstract
In 1994, the US Food and Drug Administration approved the μ-opioid receptor antagonist naltrexone to treat alcohol dependence. However, treatments requiring daily administration, such as naltrexone, are inconsistently adhered to in substance abusing populations, and constant medication exposure can increase risk of adverse outcomes, e.g., hepatotoxicity. This has fostered a ‘targeted’ or ‘as needed’ approach to opioid receptor antagonist treatment, in which medications are used only in anticipation of or during high-risk situations, including times of intense cravings. Initial studies of the ability of targeted naltrexone to reduce drinking-related outcomes were conducted in problem drinkers and have been extended into larger, multi-site, placebo-controlled investigations with positive results. Another μ-opioid receptor antagonist, nalmefene, has been studied on an ‘as-needed’ basis to reduce heavy drinking in alcohol-dependent individuals. These studies include three large multi-site trials in Europe of up to 1 year in duration, and serve as the basis for the recent approval of nalmefene by the European Medicines Agency as an ‘as-needed’ adjunctive treatment for alcohol dependence. We review potential moderators of opioid receptor antagonist treatment response including subjective assessments, objective clinical measures and genetic variants. In sum, the targeted or ‘as-needed’ approach to treatment with opioid antagonists is an efficacious harm-reduction strategy for problem drinking and alcohol dependence.
Details
- Title: Subtitle
- Targeted Opioid Receptor Antagonists in the Treatment of Alcohol Use Disorders
- Creators
- Mark Niciu - National Institutes of Health/National Institute of Mental Health, Experimental Therapeutics and Pathophysiology Branch 10 Center Dr., Building 10/CRC, Room 7-5545 Bethesda MD 20814-9692 USAAlbert Arias - VA Connecticut Health Care System/West Haven Veterans Administration Medical Center 950 Campbell Ave., Office 116-A West Haven CT 06516 USA
- Resource Type
- Journal article
- Publication Details
- CNS drugs, Vol.27(10), pp.777-787
- DOI
- 10.1007/s40263-013-0096-4
- PMID
- 23881605
- PMCID
- PMC4600601
- NLM abbreviation
- CNS Drugs
- ISSN
- 1172-7047
- eISSN
- 1179-1934
- Publisher
- Springer Science and Business Media LLC; Cham
- Language
- English
- Date published
- 10/2013
- Academic Unit
- Psychiatry; Iowa Neuroscience Institute
- Record Identifier
- 9984003487502771
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