An Evaluation of μ-Opioid Receptor (OPRM1) as a Predictor of Naltrexone Response in the Treatment of Alcohol Dependence

Abstract

While pharmacotherapy for alcohol dependence is limited, several drugs have received Food and Drug Administration approval.^1,2 Meta-analyses of many single-site and multisite studies of the opioid antagonist medication naltrexone hydrochloride have suggested that the effect size for response over placebo is in the small to moderate range.^3-6 For instance, in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) Study,⁷ naltrexone showed its prime efficacy when used in the context of medical management (MM) (number needed to treat, 6-7) but not when combined with a specialized alcohol counseling approach. On the basis of this extensive experience, it is clear that not all individuals with alcohol dependence respond to naltrexone. Attempts to identify individual factors that would be associated with a positive response have been limited and inconsistent. Therefore, any improvement in the ability to predict naltrexone response would have immense theoretical and clinical value.