The Houston Alcoholism Treatment Research Group (HATRG) in response to NIAAA RFA# AA-97-004 proposes to participate as one of the Clinical Research Units in a randomized, double-blind clinical trial which will determine the relative efficacies of two anti-craving medications (naltrexone and acamprosate), both singly and combined, as adjuncts to either a medium or minimal intensity psychosocial treatment. The trial will compare the relative efficacies of the treatment combinations and determine whether different types of alcoholics respond differently to certain combinations. A preliminary study that will determine the dosages of naltrexone, acamprosate, and the combined medications that should be used in the full scale study is also proposed. The preliminary study will also pilot and refine the two psychosocial treatments: 1. An Enhanced Motivational Enhancement Therapy protocol, delivered by trained therapists, which adds feedback on progress of change variables identified by the Transtheoretical Model and found predictive in NIAAA's Project MATCH (Stages and Processes of change, Self-efficacy to abstain, and Temptation to drink), and 2. Brief Behavioral Compliance Therapy, a low intensity program for checking and encouraging treatment compliance which can be easily delivered by staff in a managed care setting. Theoretically, these psychosocial treatments represent different points on the dimension of internal vs. external locus of control. This cooperative - agreement proposal demonstrates that the HATRG is an experienced group of alcoholism treatment investigators who have a strong track of designing and implementing collaborative and large scale clinical studies, and the capability to recruit and retain large numbers of alcohol dependent patients who meet eligibility criteria (more than 200 per year) including significant numbers of Hispanic, African American, and female patients.
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