O'Malley and associates examined the use of naltrexone, an FDA-approved medication to prevent alcohol consumption, when combined with a primary care management (PCM) or cognitive behavioral therapy (CBT) approach to patients with alcoholism. Participants in the PCM condition met individually with a healthcare provider who reviewed a treatment plan, offered advice, encouraged progress toward goals, and discussed efforts to attend AA meetings. Those in the CBT condition met individually with a therapist who helped prepare patients for high-risk situations and taught new coping skills.

In the first of three nested and randomized studies, participants received naltrexone and 10 weeks of PCM or CBT. Overall, a similar proportion of participants in both treatment approaches (85 percent) had a positive response to treatment. However, significantly more of the positive responders in the CBT group maintained total abstinence in the last month of the study (76 percent) compared to those in the PCM group (58 percent).

In the second and third studies, PCM and CBT responders from the first trial continued to receive PCM or CBT for six additional months. Participants were randomized to receive either maintenance naltrexone or placebo. Similar to the first study, participants in both conditions did well and demonstrated improved abstinence rates. Specifically, the percentage of days abstinent obtained was 90 percent for PCM + naltrexone participants and 78 percent for PCM + placebo participants, a difference that was not statistically different. However, a greater proportion of PCM + naltrexone participants (81 percent) were classified as responders (defined as no more than two heavy drinking days during any monthly period during the study) compared to the PCM + placebo group (52 percent). Among those in the CBT study, 94 percent days abstinent were obtained by those in both the naltrexone and placebo groups. In addition, the proportion of responders to CBT was equivalent regardless of the medication condition (83 percent vs. 70 percent for naltrexone and placebo, respectively).

Overall, the studies demonstrate that effective care can be delivered via cognitive behavioral and primary care management models. The results provide support for the importance of long-term care in maintaining treatment gains over time. In addition, the data suggest that the value of continued naltrexone use in long-term care is dependent upon the treatment approach used. Participants did well with CBT whether they received naltrexone or a placebo. Among PCM participants, however, those on placebo responded less favorably to treatment.

"I'm honored to receive this award," said O'Malley. "It's exciting because this award recognizes scientific work that embraces new approaches to addiction treatment. Recognition like this speaks to the prospects for looking at new settings for treatment that may improve access to care."

"The panel was impressed with the quality of Dr. O'Malley's addiction research," said Valerie Slaymaker, Ph.D., director of the Butler Center for Research. "While Hazelden's model of treatment is firmly rooted in the Twelve Step philosophy of AA, we are open to learning more about other methods that can help the suffering addict or alcoholic. This study helps us learn of different settings where care can be delivered to those who otherwise might not receive it. Hazelden's mission is to help more people find and sustain life-long recovery from addiction. To this end, the Hazelden Foundation recognizes the value of Dr. O'Malley's research."

O'Malley added, "What makes this honor special is that it reflects Dan Anderson's passion for wanting to deliver the best care possible and the need to be creative in finding the best ways to do it. The Hazelden model of care developed under Dr. Anderson changed the landscape for treating alcoholism in this country."

O'Malley's study is titled "Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs. Specialty Care." O'Malley will receive the award on April 21 at Hazelden's Substance Abuse Research Forum in St. Paul.