Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence

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Abstract
About 8 million individuals in the United States currently meet diagnostic criteria for alcohol dependence, a leading preventable cause of morbidity and mortality and a major contributor to health care costs.1-4 In primary care settings, the prevalence of alcohol use disorders ranges from 20% to 36%5; most of those patients are never treated and, if they are similar to those represented in general population data, do not receive specialty care (National Institute on Alcohol Abuse and Alcoholism [NIAAA], unpublished data).6 Primary care physicians can play a significant role in addressing alcohol use disorders.5,7,8 It is of interest whether medications for alcoholism are efficacious without specialist intervention and whether efficacy can be improved by combining different medications with or without specialist care. These questions are particularly important given that most problem drinkers are seen in health care settings, rather than in specialist treatment programs. The Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study was designed to address these issues.