Home > Clinical question: What are the effects of opioid antagonists in people with alcohol dependence?

Tort, Sera and Magalhães, Pedro V [The Cochrane Library] . (2016) Clinical question: What are the effects of opioid antagonists in people with alcohol dependence? London: Wiley. Cochrane Clinical Answers

URL: https://www.cochranelibrary.com/cca/doi/10.1002/cc...

In people with alcohol dependence, naltrexone is an effective and safe treatment to help people to refrain from drinking. Data on other opioid antagonists is limited.

Randomized controlled trials including around 4000 participants show that, compared with placebo, naltrexone results in fewer people returning to heavy or any drinking at post treatment and at 3 to 12 months, reduces drinking days, rates of heavy drinking and consumed amount per drinking at post treatment but increases the risk of adverse effects (abdominal pain, daytime sleepiness, dizziness, dyspepsia, insomnia and vomiting).

When naltrexone was compared with acamprosate, no clear benefit of one treatment over the other was seen. Similarly, naltrexone plus acamprosate was no more effective than placebo or naltrexone alone at improving outcomes. Data on nalmefene were too sparse to draw meaningful conclusions.

Item Type:Evidence resource
Publication Type:Guideline
Drug Type:Alcohol
Intervention Type:AOD disorder, AOD disorder drug therapy, AOD disorder treatment method
Source:The Cochrane Library
Date:10 March 2016
Place of Publication:London
Subjects:B Substances > Alcohol
B Substances > Opioids (opiates) > Opioid product
B Substances > Opioids (opiates) > Opioid product > Naltrexone
G Health and disease > Substance use disorder > Alcohol use > Alcohol dependence
HJ Treatment method > Substance disorder treatment method > Substance disorder drug therapy
HJ Treatment method > Treatment outcome
J Health care, prevention and rehabilitation > Patient care management
N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines

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