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Naltrexone's effectiveness as a treatment for alcohol misuse has been disappointingly modest. To explore why, researchers randomized 80 active drinkers with alcohol dependence (mean age, 47) to receive 50 mg/day of naltrexone or placebo for 12 weeks. Participants in both groups were stratified, using standardized measures, according to their liking for sweets (sweet-liking [SL] vs. sweet-disliking) and their craving for alcohol (high vs. low).
Overall, percentages of heavy-drinking days and abstinent days (the primary outcomes) did not differ significantly between the naltrexone and placebo groups. However, naltrexone was significantly more effective than placebo in reducing heavy-drinking days among SL participants and among high alcohol cr…