NIH LaunchesNational Study On Alcoholism (NAPSA)—“I was an active alcoholic from the late 1960s until the early 1980s,” says Ann Howard, a 53-year-old journalist. “T lost much of all that was impor- tant to me—a marriage, jobs, family and social relationships, health and economic security. When I finally faced the fact that I might be an alcoholic, I looked for proven treatments and found none—only About 13 percent of Americanswill experience alcoholism at sometime during theirlives. More than 50 percent report that one or moreof their close relatives has a drinking problem. ees a collection of detoxification, edu- cation, and mutual-help programs. Some of them I tried and, after three relapses across as manyyears, I eventually achieved Ten percentof people in need of treatment for alcoholism actually receives it. still do not know what worked for Of persons who receive treatment, as thing else might have workedbetter and faster to prevent huge personal losses.” To determine the mosteffective many as 50 percent relapse at least once current treatments for alcoholism, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, has launched COMBINE, a study designed to evaluate vari- ous combinations of counseling and medications. COMBINE began in March 2001 at eleven universities across the country. To date, there is no “magic bullet” cure for alcoholism, a disease characterized by impaired control over drinking, tolerance (increased drinking to achieve a desired effect), physical dependence, and, often, severe craving following sus- tained abstinence. More than four percent of U.S. adults (eight million people) are diagnosable with alcoholism (alcohol dependence) and about 13 percent experience the disease at some time during their lives. Like hypertension, cancer and manyother diseases, alcoholism is characterized by relapse. within one yearof treatment. AARAR ally guided mutual-help involvement. The behavioral treatments to be used in COMBINE are based in that knowledge.” Also during the past decade, research on medications to treat alcoholism has rapidly expanded. In 1994, the U.S. Food and Drug Administration (FDA) approved naltrexone, which interferes with the rewarding effects of alcohol and reduces the likelihood of relapse to heavy drinking. A second medication, acamprosate, is currently under review by the FDA. Acamprosate appears to help prevent drinking by relieving the sobriety. Now 20 years sober, I me, when, or how—or if some- ioral treatments and profession- A government study will define the best available treatments for alcoholism. “As manyas one-half of persons who receive treatment relapse at least once and only a minority achieve long-term remission ofdis- ease,” according to NIAAA Director Enoch Gordis, M.D. “But we know now that several specific treatments can help to reduce drinking and sustain abstinence.” “COMBINE is based on two decades of research in which NIAAAhas thoroughly tested existing treatments and workedto develop new ones,” said Richard K. Fuller, M.D., Director of NIAAA’s Division of Clinical and Prevention Research. “In 1996, Project MATCH, another ground- breaking national study, demonstrated the effectiveness of two professionally delivered behav- discomfort of alcohol withdrawal. “From our growing knowledge of the brain mechanisms in- volved in alcoholism, the search continues for optimal treatments,” said Dr. Gordis. “In the meantime, it is critical that we define and apply the best current treatments.” The eleven sites are recruiting 1,375 people 18 years and older to participate in the study. Participants will be screened for alcoholism and those who meet study criteria will receive either counseling or a combination of counsel- ing and one or more medications or a placebo. “We expect that the behavioral therapies and medications being tested in COMBINE will complement and perhaps enhance one another,” said Dr. Gordis. The study will be underwayfor more than two years, with results to be reported in about four years. To find the nearest studysite, call 1-866-80-STUDY, Mondayto Fri- day, 8:00 AM to 6:00 PM (EST). People interested in the study can also call 301-443-3860 or visit www.niaaa.nih.gov.
