People with psychotic disorders are more likely to have alcohol use disorder than the general population, but how does that comorbidity affect the course of their psychosis? This analysis of data from the CATIE study investigates that question.
Varenicline reduces smoking. Since alcohol use and tobacco use disorders are often comorbid, does the effectiveness of varenicline in reducing tobacco use translate to a similar effectiveness for alcohol-related disorders? Read this article to learn more.
Are patients with long-term excessive alcohol abuse at an increased risk for severe ventricular arrhythmia, atrial fibrillation, and sudden death? Read the results of this informative study to find out more.
Kratom has gained popularity as an inexpensive and accessible alternative to manage symptoms of opioid use disorder and pain. But, is it safe? This review provides the most up-to-date information on this psychoactive substance.
Prior research has identified several risk factors for prescription opioid use disorder (POUD). The authors attempted to develop a conceptual model for POUD based on an existing model for major depression—check out the article for details.
How does prescription opioid misuse affect people who are 50 years old and older? Are there standardized tools for assessment of misuse? What associated factors should clinicians look for when screening? Review this CME journal article for answers.
What do behavioral health providers embedded in primary care settings view as barriers to implementing brief tobacco and alcohol interventions for their patients? Read this study to find out more about this important topic.
Tapentadol has been approved for pain management and is considered to have lower abuse potential than other opioids. But, the patients in this case series had a different outcome with the drug. Read on to find out more.
While benzodiazepines are considered the standard of care for alcohol withdrawal, gabapentin is a valuable alternative that can also help with cravings and abstinence long term. Read on to find out more.
Most individuals who abuse opioids are of child-rearing age, and knowledge gaps remain regarding how this impacts their offspring. This study evaluated physical and psychiatric diagnoses of children with a parent in buprenorphine treatment.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”