Chronically homeless, alcohol-dependent individuals might benefit from a new intervention that does not require them to stop or even reduce drinking, according to the results of a preliminary study in Seattle.
Participants in the 12-week pilot program received monthly injections of an anti-craving medication, extended-release naltrexone. They also met regularly with study physicians to set their own goals for treatment and to learn to be safer in their use of alcohol.
"Abstinence-based alcohol treatment has not been effective for or desirable to many homeless people with alcohol dependence ," said Susan Collins of the University of Washington Department of Psychiatry and Behavioral Sciences. She is the lead researcher on a recently published report in the journal Substance Abuse.
The expectation that clients must change their drinking habits has been a barrier to engagement in alcohol treatment. The paper reviews the methods and findings on a new strategy for homeless clients who are not yet ready or able to stop or cutback on drinking.
People who have no permanent place to live and who are also alcohol-dependent often have several health, social, economic, legal and other problems. The study authors noted that homeless people also frequently use costly, publicly funded services, like the jail or emergency medical services.
Collins explained that her team wanted to test a new treatment to see if it would be feasible to offer, acceptable to people with this background, and capable of measurably improving their lives.
The medication chosen for this study, unlike some anti-abuse drugs, does not cause a negative reaction if alcohol is ingested, nor do clients undergo behavioral therapies that make the smell or taste of alcohol aversive. Instead, Collins said, naltrexone figuratively "acts as a pacifier to quiet brain receptors that are crying out for more alcohol." The medication safely reduces
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University of Washington