A 12-session relapse prevention program vs psychoeducation in the treatment of Japanese alcoholic patients: A randomized controlled trial.

AIM: Alcoholism is the most prevalent substance use disorder in Japan; the estimated number of patients and high-risk drinkers is in the millions. Although studies in the West have shown that cognitive behavioral therapy (CBT) is one of the most effective treatment strategies for alcoholic patients, there is a dearth of efficacy studies of CBT-based intervention for those patients in the non-Western setting. The aim of this study is to investigate the efficacy of a 12-session CBT-based relapse prevention program for Japanese alcoholic patients. METHODS: Forty-eight alcoholic patients (M = 36, F = 12) who were admitted to an addiction treatment unit were randomly allocated either to a 12-session relapse prevention (RP) program (n = 24) or a 12-session psychoeducation (PE) program (n = 24). Both treatment programs were conducted in a group format once a week for 12 weeks. Other aspects of inpatient treatment (group meetings, etc) were the same in both groups. Self-rating scales, which measure behavioral and cognitive coping, coping response, self-efficacy, and cognition of drinking, were administered at pretreatment, mid-treatment, and posttreatment periods. The proportion of participants who relapsed at 3 and 6 months after discharge was evaluated. RESULTS: Both RP and PE groups showed significant improvement in self-efficacy and cognition of drinking at posttreatment. However, there were no significant differences in the self-rating scales between both groups. In addition, there were no significant differences in relapse rate at 3 and 6 months after discharge between both groups. CONCLUSIONS: The 12-session CBT-based relapse prevention program and the psychoeducation program may be equally efficacious for alcoholic patients. Several factors that influenced the results are discussed.

A randomized controlled study of the effect of ifenprodil on alcohol use in patients with alcohol dependence.

AIM: This prospective, randomized, controlled, rater-blinded study investigated the effect of G protein-activated inwardly rectifying potassium (GIRK) channel inhibitor ifenprodil on alcohol use in patients with alcohol dependence. METHODS: The participants were 68 outpatients with alcohol dependence who were assigned to an ifenprodil group (administered 60 mg ifenprodil per day for 3 months) or control group (administered 600 mg ascorbic acid and calcium pantothenate per day for 3 months). The participants completed a questionnaire that included the frequency of alcohol drinking and presence of heavy drinking before the study period (time 1) and 3 months after the start of the study period (time 2). The alcohol use score was calculated using these two items. RESULTS: Valid data were obtained from 46 participants (25 in the ifenprodil group and 21 in the control group). The alcohol use score at time 2 in the ifenprodil group was significantly lower than that in the control group after adjusting for the score at time 1 and some covariates. The intention-to-treat analysis of multiply imputed datasets indicated similar results. Group differences in the frequency of alcohol drinking were significant in the multiply imputed datasets but not in 46 participants. The ifenprodil group had a significantly lower rate of heavy drinking at time 2 than the control group. CONCLUSIONS: This study found an inhibitory effect of ifenprodil on alcohol use in patients with alcohol dependence. The results support the hypothesis that GIRK channel inhibitors ameliorate alcohol dependence. TRIAL REGISTRY: This trial was registered in the UMIN clinical trial registry (UMIN000006347).

[Effectiveness of brief intervention for substance use disorder in Japan--a pilot study].

BACKGROUND: Relatively few hospitals can treat substance use disorder in Japan and the options for treatment are limited. Previous studies in the West have shown the effectiveness of brief intervention for substance use disorder. However, such treatment has not been sufficiently implemented in Japan. For this study, we developed brief intervention tools for substance use disorder, and conducted a pilot study to evaluate the efficacy of treatment. METHODS: Participants in this study were recruited from those admitted for substance use disorder in the addiction treatment unit of Tokyo Metropolitan Matsuzawa Hospital, and the recruitment period was from October 2013 through March 2014. The brief intervention consisted of one 30-min individual session. Four self-rating scales measuring motivation, relapse risk and self-efficacy were administered pre- and post-intervention: SOCRATES-8D, Stimulants Relapse Risk Scale, Drug Abuse Self-efficacy Scale and Visual Analogue Scale. RESULTS: Forty patients participated in this study. Subscale Scores at post-intervention that improved significantly compared to those at pre-intervention were Recognition (SOCRATES-8D); Total score and Anxiety and intention to use drug (Stimulants Relapse Risk Scale); Generalized self-efficacy (Drug Abuse Self-efficacy Scale); and Knowledge about drug abuse (Visual Analogue Scale). CONCLUSION: These results indicate that brief interventions may offer effective treatment for substance use disorder. A randomized controlled trial that contains an evaluation of abstinence rate in the follow-up period is needed to ascertain the efficacy of brief intervention for substance use disorder in Japan.