On treatment mechanisms--what can we learn from the COMBINE study?

Addiction
Anders Bergmark

Abstract

To discuss the results of combined pharmacotherapies and behavioural interventions for alcohol dependence as presented by the COMBINE study. Although the main hypothesis in the COMBINE study was to determine if improvements in treatment outcome can be achieved by combining pharmacotherapy and behavioural interventions, the lack of support for this idea in the results of the study is merely mentioned in passing, but not really discussed. Instead, the COMBINE study group claims that the results of their study constitute support for the use of naltrexone in primary care settings. However, the empirical basis for this recommendation appears somewhat weak. Furthermore, the COMBINE study group's discussions of the results could have benefited from a discussion of the treatment mechanisms that are supposed to have generated the improvement in the participants' drinking practices: what importance should we attribute to common mechanisms that are embedded in the treatment context, and what weight should we ascribe to the pharmacological interventions and the specific behavioural intervention? In the context of other major studies within the alcohol field, such as Project MATCH and the UK Alcohol Treatment Trial (UKATT) study, and contem...Continue Reading

References

Apr 22, 2000·Biological Psychiatry·I Kirsch
Dec 14, 2001·The New England Journal of Medicine·J H KrystalUNKNOWN Veterans Affairs Naltrexone Cooperative Study 425 Group
Jul 25, 2003·Alcoholism, Clinical and Experimental Research·UNKNOWN COMBINE Study Research Group
Apr 7, 2005·JAMA : the Journal of the American Medical Association·James C GarbuttUNKNOWN Vivitrex Study Group
Oct 15, 2005·Journal of Studies on Alcohol. Supplement·David GoldmanRaymond Anton
May 4, 2006·JAMA : the Journal of the American Medical Association·Raymond F AntonUNKNOWN COMBINE Study Research Group

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Citations

Apr 15, 2011·Behavioural and Cognitive Psychotherapy·Katja KuusistoPekka Saarnio
Feb 1, 2012·Journal of Consulting and Clinical Psychology·Katie WitkiewitzBryan Hartzler
Mar 10, 2010·Journal of Forensic and Legal Medicine·T P HutchinsonV L Lindsay
Apr 17, 2008·Addiction·Harold Kalant
Apr 17, 2008·Addiction·Gerhard Bühringer, Tim Pfeiffer-Gerschel
Apr 17, 2008·Addiction·Jim Orford
May 15, 2013·Addiction·Meenakshi Sabina SubbaramanJennifer Ahern
Mar 2, 2011·Drug and Alcohol Review·Fairlie McIlwraithJake M Najman
May 26, 2020·Substance Abuse Treatment, Prevention, and Policy·Katja Kuusisto, Tomi Lintonen

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