{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:08:41Z","timestamp":1772003321641,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T00:00:00Z","timestamp":1518393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01AA017633"],"award-info":[{"award-number":["R01AA017633"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K05AA017435"],"award-info":[{"award-number":["K05AA017435"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The opioid antagonist naltrexone is not efficacious for every alcohol treatment seeker. However, various individual factors, such as genetic differences and nicotine\u2010use\/smoking status, have been suggested as predictors of naltrexone response. In a randomized clinical trial, we previously reported that nicotine\u2010use\/smoking status might be a stronger predictor of naltrexone efficacy than <jats:italic><jats:styled-content style=\"fixed-case\">OPRM<\/jats:styled-content>1<\/jats:italic> A118G single nucleotide polymorphism (<jats:styled-content style=\"fixed-case\">SNP<\/jats:styled-content>) genotype. In this report, we further characterize the nicotine\u2010users in that trial, examine other drinking outcomes, examine the influence of smoking change on naltrexone effects on drinking, and validate the result in smokers with disialo carbohydrate\u2010deficient transferrin (%<jats:styled-content style=\"fixed-case\">dCDT<\/jats:styled-content>) change as an independent biomarker of response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Individuals (<jats:italic>n<\/jats:italic>\u00a0=\u00a0146) meeting <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> criteria for alcohol dependence who were genotyped for the <jats:italic><jats:styled-content style=\"fixed-case\">OPRM<\/jats:styled-content>1<\/jats:italic> A118G <jats:styled-content style=\"fixed-case\">SNP<\/jats:styled-content> and who did, or did not, use nicotine\/cigarettes were randomized, in a balanced fashion, to naltrexone (50\u00a0mg\/d) or placebo and provided medical management (MM) over a 16\u2010week clinical trial. Alcohol use and smoking during the trial were assessed and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nicotine\u2010use\/smoking status significantly interacted with medication in reducing percent heavy drinking days (<jats:styled-content style=\"fixed-case\">PHDD<\/jats:styled-content>) during the trial (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), such that nicotine\u2010users\/smokers showed significantly lower <jats:styled-content style=\"fixed-case\">PHDD<\/jats:styled-content> on naltrexone versus placebo (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001, Cohen's <jats:italic>d<\/jats:italic>\u00a0=\u00a00.89), while nonusers showed no significant difference between naltrexone and placebo (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.95, Cohen's <jats:italic>d<\/jats:italic>\u00a0=\u00a00.02). Similar effects were shown for drinks per day and percent days drinking. The superiority of naltrexone over placebo on <jats:styled-content style=\"fixed-case\">PHDD<\/jats:styled-content> reduction in nicotine\u2010users\/smokers was confirmed with %<jats:styled-content style=\"fixed-case\">dCDT<\/jats:styled-content> (Cohen's <jats:italic>d<\/jats:italic> range 0.3 to 0.9 over the study). Naltrexone did not significantly change cigarette use in smokers, and change in use did not influence naltrexone's effect on <jats:styled-content style=\"fixed-case\">PHDD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These data confirm past findings that naltrexone is more efficacious in those who use nicotine\/cigarettes. Compared to previous work on the <jats:italic><jats:styled-content style=\"fixed-case\">OPRM<\/jats:styled-content>1<\/jats:italic> A118G <jats:styled-content style=\"fixed-case\">SNP<\/jats:styled-content>, it appears that nicotine\u2010use might be a more salient predictor of naltrexone treatment response. While naltrexone did not change cigarette use during the study, and smoking change was not related to alcohol reduction, it should be noted that participants were not seeking smoking cessation and MM did not address this issue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.13601","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T15:02:39Z","timestamp":1518447759000},"page":"751-760","source":"Crossref","is-referenced-by-count":26,"title":["Nicotine\u2010Use\/Smoking Is Associated with the Efficacy of Naltrexone in the Treatment of Alcohol Dependence"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3417-6576","authenticated-orcid":false,"given":"Raymond F.","family":"Anton","sequence":"first","affiliation":[{"name":"Addiction Sciences Division Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston South 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