"Oral naltrexone was approved by the Food and Drug Administration in 1994," explained Henry R. Kranzler, a professor in the department of psychiatry at the University of Connecticut Health Center and corresponding author for the study. "It was the first medication approved to treat alcohol dependence since disulfiram was approved in 1949, and its approval was based on a demonstration of efficacy using a randomized, controlled trial design. The FDA has since approved acamprosate and long-acting naltrexone."

Kranzler believes that oral naltrexone is covered by most health plans as a generic drug.
For this study, Kranzler and his colleagues used data from the MarketScan Commercial Claims and Encounters Database for 2000 to 2004 to create three groups: a naltrexone group (n=1,138) with an alcohol-related diagnosis and at least one pharmacy claim for oral naltrexone; an alcohol control group (n=3,411) with an alcohol-related diagnosis but no prescription for alcoholism-treatment medication; and a non-alcohol control group (n=3,410) with no alcohol-related diagnosis and no prescription for alcoholism-treatment medication. The two groups with an alcohol-related diagnosis were matched to each other on a variety of demographic and clinical dimensions. Healthcare expenditures were calculated for the six-month periods before and after naltrexone drug claims, and dates were matched for the two control groups.

"We found that, prior to the start of the study period, individuals treated with naltrexone had higher healthcare costs than the group with an alcohol-related diagnosis but no naltrexone treatment," said Kranzler. "However, during the period after receiving the medication, the naltrexone group showed a significantly smaller increase in healthcare expenditures (both alcohol-related and non-alcohol-related) than the group with an alcohol-related diagnosis but no naltrexone treatment." In other words, oral naltrexone seemed to reduce healthcare costs for patients with an alcohol-related diagnosis.

Kranzler said these findings have implications for two groups. "I think that the greatest applications of these results are for healthcare policy makers, treatment-program managers, insurance companies, and health-benefits managers," he said. "They also show researchers that developments in treatment can pay dividends in cost savings."
Furthermore, he added, this study shows there is a common ground between effective treatment measures and cost-savings.

"As a physician, I am interested in all treatments that can alleviate suffering and improve people’s lives, however, I am also cognizant of the need to contain healthcare costs. This study suggests that an alcoholism treatment medication can help to contain healthcare costs and that wider consideration of the economic value of such approaches is warranted."

It is natural to feel uncomfortable taking your first steps toward recovery.  When we abuse alcohol or drugs, we spend a lot of energy trying to disguise and hide our addiction.  We keep a lot of secrets.  Breaking that tradition of secrecy can make us anxious and panicky. 

"I remember the day I called the employee assistance program. I knew I was in trouble.  I wanted to talk to somebody.  I did not want to admit it was about alcohol, but something in me – I like to think of it as a survivor instinct – pushed me to say it immediately in the phone call: I think I have a problem with alcohol.  The cat was out of the bag!  I felt relief, which was quickly followed by regret.  I now knew they would ask me about it in my first session. Oh boy. What if I still wanted to drink?  I knew alcoholics couldn’t drink.  But the relief part was great – now I couldn’t hide it. I had taken the first and most important step. I was on the road to recovery."  – DA, recovering alcoholic

Asking for help isn’t easy, but it’s critical to getting on the path to recovery.  There is a saying in AA – you are only as sick as your secrets.

If you have extreme anxiety about "letting the cat out of the bag" remember this: it’s probably not as big a secret as you think.  If you abuse alcohol, people will figure it out. Your behavior and your health will certainly give you away at some point.

Some initial ways to ask for help are:

Call Alcoholics Anonymous and talk to someone in recovery

Attend an Alcoholics Anonymous meeeting (it’s ANONYMOUS and you don’t have to introduce yourself if you don’t want to)

Call your employee assistance program and make an appointment

Find a therapist who specializes in addiction and recovery

If you know someone in recovery, ask them if you can talk to them privately

Call a treatment center that specializes in alcohol rehabilitation and talk to a counselor

Sometimes the best way to choose the right alcohol rehab for your needs is to work with a clinical professional (psychologist, therapist, or social worker) who has some experience with addiction treatment. Often these professionals have taken the time to research various alcohol rehabs and assess the quality of their clinical program.

You can also call an alcohol rehab directly and ask them specific questions about your treatment and about the rehab in general:

1. How long has the facility been treating alcoholism?

2. What are the qualifications of the staff?

3. What will a typical day be like – group therapy (generally the best type of recovery treatment), recreational activities?

4. What is their therapeutic philosophy?  Do they use cognitive behavioral therapy?

5. How much of a foundation of the alcohol rehab is built on 12-step philosophy (critical for long-term success)

6. Do they have a strong alumni network (this will be important in the months after treatment)

7. What sort of after care do they offer?

8. If you have any special needs, how will they help you (e.g., dietary restrictions; bipolar or other co-occurring disorder)