Deficits in anxiety management skills are frequent causes of relapse to alcohol use. Empirical data support the role of anxiety in alcohol relapse. Psychosocial and pharmacological treatments for alcohol problems increasingly address the role of negative affect in alcohol use disorders. Due to the lack of large, well-controlled treatment outcome trials, the optimal treatment (or combination of treatments) remains unknown. Real world practice in the treatment of alcohol use disorders frequently begins brief, intensive detoxification and stabilization, and is often followed by some combination of CBT and pharmacotherapy for patients complaining of mood difficulties while attempting early abstinence from alcohol. The proposed project is written as a """"""""typical clinical practice"""""""" test in response to the Program Announcement PA-98-003, and is a fully-controlled trial of a combined anxiety-focused CBT and pharmacotherapy (venlafaxine; CBT-VEN) delivered for patients with comorbid alcohol-use and anxiety disorders. The CBT-VEN package will be administered in three forms depending upon the primary presenting anxiety disorder (i.e., PD, GAD, or SP) and will be contrasted with two single-active treatment conditions (CBT-PLA and REL-VEN), and one fully-controlled condition (relaxation training and placebo medication; REL-PLAC). One hundred and twenty eight participants will be recruited and, subsequent to a platform of intensive outpatient treatment for alcoholism, will be randomly assigned to a 12-week treatment condition. Both conditions will begin with a 1-week placebo run-in, and conclude with a 3-week medication taper. Follow-up assessments will be conducted at post-treatment and at 3, 6, 9, and 12-months. The long-term objectives of this research are to develop a real-world combination of psychosocial and pharmacological treatments for patients with comorbid alcohol-use and anxiety disorders that compromise prognosis, and to evaluate the effectiveness of combined psychosocial and pharmacological treatments that target anxiety among patients with this comorbidity.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA013727-03
Application #
6929931
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Roach, Deidra
Project Start
2003-09-30
Project End
2008-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
3
Fiscal Year
2005
Total Cost
$520,425
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
02118
Conklin, Laren R; Cassiello-Robbins, Clair; Brake, C Alex et al. (2015) Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders. Behav Res Ther 73:124-30
Ciraulo, Domenic A; Barlow, David H; Gulliver, Suzy Bird et al. (2013) The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders. Behav Res Ther 51:729-35
Farchione, Todd J; Fairholme, Christopher P; Ellard, Kristen K et al. (2012) Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther 43:666-78
Streeter, C C; Gerbarg, P L; Saper, R B et al. (2012) Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses 78:571-9
Morissette, Sandra B; Gulliver, Suzy B; Kamholz, Barbara W et al. (2008) Differences between daily smokers, chippers, and nonsmokers with co-occurring anxiety and alcohol-use disorders. Addict Behav 33:1425-31
Knapp, Clifford M; Mercado, Melissa; Markley, Tara Lynn et al. (2007) Zonisamide decreases ethanol intake in rats and mice. Pharmacol Biochem Behav 87:65-72
Sim, Minyoung E; Lyoo, In Kyoon; Streeter, Chris C et al. (2007) Cerebellar gray matter volume correlates with duration of cocaine use in cocaine-dependent subjects. Neuropsychopharmacology 32:2229-37
Streeter, Chris C; Jensen, J Eric; Perlmutter, Ruth M et al. (2007) Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med 13:419-26
Gulliver, Suzy Bird; Kamholz, Barbara W; Helstrom, Amy W (2006) Smoking cessation and alcohol abstinence: what do the data tell us? Alcohol Res Health 29:208-12