This article reports the results of a large scale study that analyzed the treatment of alcoholism with naltrexone for patients with and without the gene Asp40. The study followed subjects undergoing treatment at 11 academic medical sites. All participants received medical management and some received "combined behavioral intervention." Half of the patients received naltrexone and the other half received placebo.

Patients treated with naltrexone for alcohol abuse who had at least one copy of the Asp40 allele showed an increasing trend in abstinence over time, while results of naltrexone treatment in those without the Asp40 allele was similar to placebo, showing fewer abstinent days over time. No significant differences were seen between outcomes for naltrexone patients with medical management regardless of whether or not they received behavioral counseling.

The study does not make a conclusion as to the impact of combined behavioral intervention but notes that such interventions "may obscure meaningful biological effects of genes on which a specific medication can act."

In summary, the article reports that patients with the gene Asp40 responded positively to naltrexone with or without additional behavioral intervention.

Comments by Tom Delaney, MSW, MPA
Alcoholism counselors are seeing an increasing number of studies, reports, and marketing data indicating that naltrexone is an effective medication for the treatment of alcohol abuse. The question of which patients might be better served by this treatment has often not been raised. Alcoholism counselors should be encouraged that this question is being addressed in large, robust, and controlled studies. This study also provides a window to glance at the potential for gene studies to contribute to the treatment of alcohol abuse.