Prazosin Alcohol Dependence IVR Study
AlcoholismThis double-blind placebo controlled pilot trial will test the hypothesis that prazosin, an alpha-1 adrenergic receptor antagonist, reduced alcohol consumption and alcohol craving in alcohol dependent individuals without Post Traumatic Stress Disorder (PTSD). The intervention period is six weeks.
Impact of a Brief Motivational Interview on Drinking Behaviors of At Risk Drinkers Screened in the...
Alcohol AbuseAlcohol abuse is associated with injury, chronic illness, absenteeism from work, and social costs to families and communities. The goal of this project is to translate motivational interventions successful in the primary care setting to the Emergency Department (ED) environment by implementing screening, brief intervention and referral to treatment (SBIRT) in order to reduce at-risk drinking among ED patients.
Intensive Intervention for Smokers - 6
Tobacco Use DisorderAlcohol DependenceThe purpose of this study was to determine the efficacy and cost-effectiveness of an intensive smoking cessation intervention that utilizes extended cognitive-behavioral therapy and combination nicotine replacement (CNR) in a randomized controlled trial. The intensive intervention was compared to usual care involving referral to a free-standing smoking cessation program that provides brief counseling and CNR. We recruited 162 smokers, ages 18 to 75, who are enrolled in the Drug and Alcohol Treatment (DAT) programs at the San Francisco VA Medical Center (SFVAMC) and Santa Rosa VA Community-based Outpatient Clinic (CBOC). To be eligible, participants had to be abstinent from alcohol for at least one week, but not more than 30 days. We compared outcomes for the two study arms by assessing biochemically-validated point-prevalence smoking status at 3, 6, 9, and 12 months post-baseline and continuous abstinence over the 12-month follow-up. Expired-air carbon monoxide (CO) was used to biochemically verify 7-day point prevalence abstinence. We also conducted an economic analysis to determine the cost-effectiveness of the intensive intervention compared with usual care. We also examined cross-relapse patterns during the follow-up period, assessing changes in mood states and use of tobacco, alcohol, and other drugs at 3, 6, 9, and 12 months.
Post-Treatment Effects of Naltrexone
AlcoholismThe aims of this protocol are to compare 3 and 6 months of naltrexone treatment coupled with two psychotherapies that differ in scope and intensity. The effect of these treatments will be assessed with patients who differ in their psychosocial need and resources at their disposal, and in their level of cravings for alcohol.
Drug Treatment for Depressed Alcoholics (Naltrexone/Fluoxetine)
AlcoholismAlcohol Dependence1 moreThis study will examine the effects of combing naltrexone and fluoxetine (Prozac) versus fluoxetine and placebo in alcoholics with co-occurring major depression. Both groups will actively participate in the 6-month study, which includes weekly individual Dual Disorders Recovery Counseling during the first month and every two weeks during the second through sixth months, plus the naltrexone and fluoxetine or fluoxetine and placebo. Subjects will complete follow-up assessments at 9 and 12 months.
Comparing Gabapentin and Lorazepam for Treating Alcohol Withdrawal
AlcoholismThis study will evaluate a safe and useful medication for outpatient detoxification that is as effective as benzodiazepines in the short-term, and more effective in the protracted withdrawal period. Gabapentin (Neurontin) will be compared to a standard benzodiazepine, lorazepam (Ativan), for its effectiveness in treating alcohol withdrawal.
Drug Treatment for Alcoholics With Bipolar Disorder
AlcoholismBipolar DisorderThe purpose of this study is to test the effectiveness of sodium valproate (Depacon) in treating individuals with alcohol dependence and comorbid bipolar disorder.
Use of Naltrexone in a Clinical Setting
AlcoholismThis 12-week trial will compare individuals receiving naltrexone or placebo plus substance abuse counseling therapy versus those receiving only substance abuse counseling therapy in a rural, nonacademic setting. A followup period of 12 months is included. The effect on service utilization and the cost of the addition of naltrexone to treatment services for alcohol dependence also will be assessed. The study will expand existing research concerning the effectiveness of naltrexone in clinical trials versus a clinical setting.
Brain Connectivity Between Networks Implied in Inhibition and Cue-reactivity in Alcohol Use Disorder...
Alcohol Use DisorderResearch about patients with alcohol use disorder has shown that task-related brain activation patterns as well as resting-state connectivity (measured with functional magnetic resonance imaging) change with clinical parameters such as the extent of craving and duration of abstinence during treatment. These brain activation alterations are related to treatment success. Although an imbalance between increased cue-reactivity and impaired counteracting inhibitory control processes are at the core of most neuropsychological conceptualizations of alcohol use disorder, the direct interaction between these two processes has not yet been investigated. Therefore, the investigators aim to study patients with alcohol use disorder in an ultra-high-field 7 Tesla magnetic resonance imaging scanner to identify fine-grained activation and connectivity patterns. The investigators would like to improve the knowledge of the interplay between the brain networks for inhibition and cue-reactivity, as well as to explore its influence on craving and treatment success. The investigators hypothesize that a more pronounced negative relationship between increased cue-reactivity and reduced inhibitory control processes in the brain is linked to higher craving and worse relapse probability.
Brief Family-involved Treatment for Alcohol Use Disorder
Alcohol Use DisorderFamily-involved treatments for alcohol use disorders (AUDs) hold considerable promise to improve engagement and compliance with treatment and improve treatment outcomes. Currently, however, these treatments are time-intensive and difficult to learn and to integrate with on-going clinical treatment. Consistent with the general trend toward briefer treatments, we propose to develop a brief, 3-session, family-involved treatment that can be incorporated into a variety of other AUD treatment modalities. If successful, the treatment may increase the efficiency and effectiveness of AUD treatment.