The proposed study is a randomized clinical trial to assess the effectiveness of two alcoholism treatment interventions first developed and evaluated by Nathan Azrin. The Disulfiram Compliance (DC) intervention involves a supporting and reinforcing """"""""monitor"""""""" to ensure patient medication compliance. The Community Reinforcement Approach (CRA) is a broad- spectrum treatment procedure. Both have been found, in Azrin's work, to be substantially superior standard alcoholism treatment methods. The present study will replicate and extend Azrin's research, studying a culturally diverse population treated in a metropolitan public outpatient treatment facility. Disuliram- eligible patients will be assigned randomly to one of four groups: representative """"""""generic"""""""" alcoholism treatment with or without the DC component, or the full CRA program with or without disulfiram. In a separate randomization, disulfiram-ineligible patients will be assigned to either generic treatment or CRA (without disulfiram). Methodological improvements over prior CRA research include: (1) extension of follow-up to 3 years; (2) specification of generic treatment components; (3) delivery of generic treatment by therapists committed to this approach; (4) double-blind intake assessment and single-blind follow-up assessment; (5) inclusion of a broader range of pretreatment assesement measures to enable the development of treatment matching schemas; (6) inclusion of a disulfiram-ineligible population and greter cultural diversity; and (7) evaluation of the contribution of disulfirma to the CRA program. CRA procedures are highly compatible with and exportable to traditional alcoholism treatment settings, and show promise of substantially improving overall therapeutic effectiveness, reducing long-term relapse risk and improving health and social functioning of recovering alcoholics.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA007564-02
Application #
3111331
Study Section
Alcohol Psychosocial Research Review Committee (ALCP)
Project Start
1988-03-01
Project End
1992-02-28
Budget Start
1989-03-01
Budget End
1990-02-28
Support Year
2
Fiscal Year
1989
Total Cost
Indirect Cost
Name
University of New Mexico
Department
Type
Schools of Arts and Sciences
DUNS #
829868723
City
Albuquerque
State
NM
Country
United States
Zip Code
87131
Grant, K A; Arciniega, L T; Tonigan, J S et al. (1997) Are reconstructed self-reports of drinking reliable? Addiction 92:601-6