This study will develop a behavioral and drug relapse prevention program for individuals who
are dependent on both alcohol and tobacco. The study's goal is to show that individuals
receiving nicotine replacement therapy and naltrexone (Revia) with behavior therapy will
have higher rates of abstinence from both smoking and drinking than individuals who do not
receive the drug therapies. Individuals will be placed in a 12-week outpatient treatment
program with followup assessments 1, 3, and 6 months after treatment.
- Meets criteria for alcohol and nicotine dependence.
- Individuals will be outpatients with alcohol and nicotine dependence who have
completed detoxification (medicated or nonmedicated) within the past 48-120 hours.
- Smoking no less than 10 cigarettes/day and no greater than 50 cigarettes/day.
- Motivated to quit smoking.
- Willing and able to participate in the 12 week outpatient treatment.
- Acceptable health.
- Able to provide a collateral informant.
- Willing to be followed for 6 months after treatment ends.
- Willing and able to provide the names of three family members or friends to aid in
locating participants for follow-up.
- Current diagnosis of dependence on other substances except nicotine and alcohol.
- Having moderately severe or severe alcohol withdrawal symptoms.
- Recent (less than 48 hours) evidence of hazardous drinking (more than 2 drinks/day
for females; 3 drinks/day for males).
- History of opioid abuse.
- Recent use of cocaine.
- Not desiring to quit smoking.
- Recent past or current pharmacotherapy involving naltrexone or transdermal nicotine
- History of psychosis.
- Current suicidality, homicidally or psychiatric symptoms requiring other medications.
- Presence of medical abnormalities that contraindicate naltrexone or nicotine
- Current treatment with psychotropic medications.
- Pregnancy or nursing for female patients. Inability or unwillingness to participate
in the 12-week outpatient treatment.