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Background Post hoc analyses of 2 randomized controlled trials suggest naltrexone may reduce alcohol use and improve smoking cessation outcomes among heavy drinkers receiving smoking cessation treatment. However, no studies have been conducted specifically to examine naltrexone for this purpose or to test whether naltrexone has benefit when added to smoking cessation counseling that explicitly addresses heavy drinking. Methods We recruited heavy-drinking smokers from the community and randomized them to receive 10 weeks of either (i) 50 mg naltrexone ( n = 75) or (ii) placebo ( n = 75) daily. Participants received 6 weeks of transdermal nicotine patch and 6 sessions of counseling that addressed both heavy drinking and smoking. Participants were followed for 26 weeks after their target quit smoking date. Results Across medication conditions, there were substantial reductions at follow-up in percent heavy drinking days (primary outcome) and average drinks per week (secondary outcome). However, participants receiving naltrexone did not differ significantly from those receiving placebo on percent heavy drinking days (effect size d = −0.04, 95% CI [−0.30, 0.22], p = 0.76) or average drinks per week ( d = −0.09, 95% CI [−0.35, 0.18], p = 0.54) during follow-up. Naltrexone compared to placebo was not associated with a significant increase in smoking abstinence rates during follow-up, odds ratio = 0.93, 95% CI [0.46, 1.86], p = 0.83. The effect of naltrexone on these outcomes was not significantly moderated by current alcohol dependence or gender. Conclusions Results indicate that heavy-drinking smokers, including those with current alcohol dependence, can make substantial reductions in drinking in the context of smoking cessation treatment. However, this study provided no evidence that naltrexone is efficacious for enhancing reductions in drinking or improving smoking cessation in this population. Limitations of this study included lower-than-desired sample size and modest adherence to study medication. [ABSTRACT FROM AUTHOR]

Background: Rates of smoking among adolescents with psychiatric comorbidity are high, despite the well-known health risks. The current longitudinal study examined patterns of quitting behavior in adolescent smokers with psychiatric comorbidity.Methods: The study evaluated 191 inpatient adolescents who had been enrolled in a randomized controlled trial of motivational interviewing versus brief advice for smoking cessation, and assessed their intentions to quit smoking.Results: Rates of quit attempts at post-hospital, 1-month, and 6-month assessments were 23%, 17%, and 17%, respectively. Adolescents who reported an intention to quit smoking (43%) were significantly more likely to report a quit attempt, regardless of psychiatric symptoms, cognitive factors, or substance use.Conclusions: Intention to quit smoking appears to translate to substantial quit behavior, even in a high-risk adolescent population that may otherwise be viewed as uninterested in quitting, suggesting the need to proactively connect this population with adequate services and follow-up support. (Am J Addict 2013;XX:1-6). [ABSTRACT FROM AUTHOR]

Aims The efficacy of batterer intervention programs to reduce intimate partner violence ( IPV) is questionable, with individuals with alcohol problems particularly unlikely to benefit. We examined whether adding adjunctive alcohol intervention to batterer intervention reduced the likelihood of substance use and violence relative to batterer intervention alone. Design Randomized clinical trial. Setting Batterer intervention programs in Rhode Island, USA. Participants A total of 252 hazardous drinking men in batterer intervention programs. Participants were randomized to receive 40 hours of standard batterer program ( SBP) or the SBP plus a 90-minute alcohol intervention ( SBP + BAI). None withdrew due to adverse effects. Data were collected at baseline, 3-, 6- and 12-month follow-up, with follow-up rates of 95, 89 and 82%, respectively. Measurements Substance use was measured with a well-validated calendar-assisted interview. Violence was measured with a validated questionnaire. Arrest records were obtained for all participants. The primary substance use outcome was drinks per drinking day ( DPDD) and the primary violence outcome was frequency of any physical IPV. Findings Relative to SBP alone, men receiving SBP + BAI reported consuming fewer DPDD at 3-month follow-up [ B = −1.36, 95% confidence interval ( CI): −2.65, −0.04, P = 0.04] but not 6- or 12-month follow-up. In secondary analyses, men receiving SBP + BAI reported significantly greater abstinence at 3- ( B = 0.09, 95% CI: 0.03, 0.14, P = 0.002) and 6-month ( B = 0.06, 95% CI: 0.01, 0.11, P = 0.01) follow-up but not 12-month follow-up. There were no significant differences in physical IPV between men receiving SBP and men receiving SBP + BAI. In secondary analyses, men receiving SBP + BAI reported less severe physical aggression at 3-month ( IRR = 0.18, 95% CI: 0.05, 0.65, P = 0.009) but not 6- or 12-month follow-up. Men receiving SBP + BAI reported less severe psychological aggression ( B = −1.24, 95% CI: −2.47, −0.02, P = 0.04) and fewer injuries to partners at 3- and 6-month follow-up ( IRR = 0.33, 95% CI: 0.12, 0.92, P = 0.03), with differences fading by 12 months. Conclusions Men with a history of intimate partner violence and hazardous drinking who received a batterer intervention plus an alcohol intervention showed improved alcohol and violence outcomes initially, but improvements faded by 12 months. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine if combined psychotherapy and pharmacotherapy reduces reported depressive symptoms compared to an assessment only condition for active drug injectors over nine months. Using a randomized controlled trial at an outpatient academic research office, the researchers applied psychotherapy (eight sessions of cognitive behavioral therapy) plus pharmacotherapy (citalopram) to active injection drug users with a DSM-IV diagnosis of major depression, dysthymia, substance-induced mood disorder with symptoms persisting for at least three months, or major depression plus dysthymia, and a Modified Hamilton Rating Scale for Depression (MHRSD) score greater than 13. The MHRSD scale scores were then assessed at the completion of three, six, and nine months. Participants (n = 109) were 64% male and 82% Caucasian, with a mean baseline MHRSD score of 20.7. Depression subtypes included major depression only (63%), substance-induced depression (17%), and double-depression (17%). Study retention at nine months was 89%. At the completion of three months of acute treatment, 26% of combined treatment patients (n = 53), compared to 12% of control patients (n = 56), were in remission (p = .047). At both six and nine months, the between-group differences in remission rates and mean MHRSD scores were insignificant, although the overall mean MHRSD score decreased from baseline (p < .01). At all follow-up assessments, depression remission was significantly associated with lower heroin use. Among active drug injectors diagnosed with depression, symptoms decline over time. Combined treatment is superior to an assessment-only condition in depression remission rates at the end-of-treatment, but this difference does not persist. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor concerning smoking and alcohol use in women arrested for domestic violence.

This article aims to study the relationship between domestic violence intervention programs and cigarette smoking and substance abuse among men in the U.S. Cigarette smoking and substance use/abuse were assessed from a sample of men who were arrested for domestic violence and court-referred to batterers' interventions programs. Data gathered on the prevalence of cigarette smoking among batterers suggest that domestic violence intervention programs should routinely screen for smoking, advice that participants should try to quit smoking, and offer assistance for those who choose to quit.