Contact:

Judith Arroyo, (505) 768-0218 or Steve Carr, (505) 277-1821

March 9, 2001

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM IMPLEMENTS NEW “COMBINE” PROGRAM
UNM’s CASAA One of 11 Treatment Centers

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) announced today the beginning of Combining Medications and Behavioral Interventions (COMBINE), a nationwide study that targets persons who have been diagnosed with alcohol dependence, commonly known as alcoholism. The Center on Alcoholism, Substance Abuse and Addictions (CASAA) at the University of New Mexico is one of 11 centers nationwide, and one of only four in the Western U.S. participating in the national study designed to determine the effectiveness of behavioral treatments alone and in combination with medications.

“One of the exciting things about this study is that Albuquerque is one of only ten cities where this study is providing state-of-the-art, innovative and well-researched treatment approaches,” said Judith Arroyo, Ph.D. project coordinator. “This is an important resource to make available to citizens of New Mexico. The people we enroll as part of the program will receive a lot of specialized attention and services including an initial consultation, physical exams, medical follow-up, medication management and behavioral intervention.”

The principal investigator at CASAA for the COMBINE study is Dr. William Miller, Co-Director of CASAA. Miller holds the rank of Distinguished Professor of Psychology and Psychiatry, and is well-known for developing effective therapeutic methods, some of which are included in the treatment being offered in COMBINE. He also heads, at CASAA, the national training site for psychotherapies being used nationwide in COMBINE.

The COMBINE study begins at a time when advances in genetics, neuroscience and treatment research are forging new directions for alcoholism treatment and building expectations among patients, clinical practitioners and the public for improved treatment results. The COMBINE study will enroll more than 1,300 people with alcohol dependence nationwide over the course of the next 24 months, 125 of whom will come from New Mexico and be treated at CASAA.

Participants will receive one or both of two behavioral treatments for 4 months, and most will also receive one or both of two medications shown to help people stay sober. One medication is naltrexone, and the other, not yet available outside research studies in the United States, is acamprosate. After treatment, CASAA staff will continue to follow patients for up to three years.

“An exciting thing about the COMBINE study,” Dr. Miller says, “is that each of the methods being studied has already been well supported in its own right as an effective help for people who want to quit drinking. It makes sense that combining these methods may yield the best available treatment for alcohol dependence.”

Dr. Arroyo agrees: “We are putting together some of the best alcohol treatment methods, to make combinations that we think will give people a good headstart on sobriety. Two of the key factors in understanding alcohol problems are biology and the person’s social environment. We will be addressing both in COMBINE.

According to current research, the most promising pharmacologic treatments are naltrexone, which was approved by the U.S. Food and Drug Administration (FDA) in 1994, and acamprosate, which has been in use in Europe for about 14 years and is currently under review by the FDA. Naltrexone, an opioid blocker, interferes with brain neurotransmitter systems that produce the rewarding effects of alcohol. Researchers have shown that naltrexone-treated patients are less likely to relapse to heavy drinking. Acamprosate is believed to normalize abnormalities in the glutamate and GABA neurotransmitter systems involved in alcohol withdrawal and may ease the discomfort of abstinence, thereby helping to prevent drinking.

Among other questions, COMBINE will explore are whether treatment effectiveness is improved by pairing a medication that reduces the risk of any drinking with one that reduces the risk of heavy drinking.

Alcohol dependence, the most severe condition in the spectrum of alcohol-related problems, affects approximately 13 percent of Americans at some time during their lives. Chronic, heavy drinkers are prone to cirrhosis and other liver-related diseases, neurological disorders, cardiovascular damage, pancreatic disease and certain cancers. About one in four urban hospital beds is occupied by a patient being treated as a result of excessive drinking. In addition to the eight million Americans who currently suffer from alcohol dependence, about six million meet diagnostic criteria for alcohol abuse disorder, a pattern of harmful or hazardous drinking that persists despite interpersonal, social, employment or legal problems, which doesn’t entail physiological addiction. Millions more engage in risky drinking patterns that could lead to alcohol problems including impaired productivity, property damage and injuries.

The COMBINE study is recruiting people age 18 years and older. Participants must be willing to take part in assessment over a three-year period, and be abstinent for a minimum of four and a maximum of 21 days prior to entering the study. People from other parts of the country who are interested in participating may determine their geographic eligibility by calling 886-80-STUDY or 886-807-8839. Interested participants locally may call the CASAA COMBINE program directly at (505) 768-0159 or (505) 768-0260.

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The University of New Mexico
Public Affairs Department
Hodgin Hall, 2nd floor
Albuquerque, NM 87131-0011
Telephone: (505) 277-5813
Fax: (505) 277-1981