Naltrexone Injections: Helping Homeless

naltrexoneA preliminary study from the University of Washington found that homeless alcoholics who received monthly injections of an anti-craving medicine experienced fewer cravings and consumed less alcohol.[1] Participants who took part in the 12-week study met regularly with study physicians to set goals for treatment and receive monthly injections of extended-released naltrexone.1

This medicine does not cause a bad reaction when alcohol is consumed.1 “Instead, it acts as a pacifier to quiet the brain receptors that are crying out for more alcohol, ” said clinical psychologist Susan Collins, PhD, of the University of Washington Department of Psychiatry and Behavioral Services. “Abstinence-based alcohol treatment has not been effective for, or desirable to, many homeless people with alcohol dependence.”1

For alcohol treatment programs for the homeless, one problem is the expectation that they must change their drinking habits.1 Alcohol-dependent homeless people often have other health, social, economic, legal, and other problems, as well, making it difficult for them to change.1 Therefore, Collins and colleagues wanted to test a new and practical treatment for them.1

The counseling approach had a non-judgmental, empathetic style—unlike traditional treatments where participants are expected to embrace sobriety.1 Instead, participants were completely in control of their own goal-setting.1 When asked, “What would you like to see happen for yourself,” many responded with cutting back on drinking, reconnecting with families, finding work, fixing health problems, and improving personal hygiene.1

The participants were also given safe drinking tips and reminded of the warning signs of  alcohol withdrawal.1 “Suddenly stopping drinking can be a serious hazard for people with severe alcohol dependence,” said Collins. “Often their bodies literally depend on alcohol to survive.”1

The results of the naltrexone injections yielded decreases in alcohol craving (33 percent), drops in amount of alcohol consumed on typical and peak drinking days (25 percent and 34 percent, respectively), decrease in frequency of alcohol use (17 percent), and decrease in problems associated with alcohol use (60 percent).1

“We think the initial results suggest that extended-release naltrexone and harm reduction counseling is a promising means of supporting reductions in alcohol use and in reducing alcohol-related harm among chronically homeless, alcohol-dependent individuals,” the researchers said. “At the same time, the findings should not be over-interpreted. This was a small, single-arm, open-label study. Larger-scale, well controlled studies are needed to test treatment efficacy.”1

[1] Pedersen, T. (2014). Anti-Craving Drug, Counseling Help Homeless Cut Back. Psych Central. Retrieved on May 28, 2014, from http://psychcentral.com/news/2014/05/25/anti-craving-drug-counseling-help-homeless-safely-consume-less-alcohol/70347.html

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