Proceedings of a symposium at the 2002 RSA/ISBRA Meeting in San Francisco, California; organized and co-chaired by Janice C. Froehlich and Stephanie O'Malley. The presentations were (1) Introduction, by Janice C. Froehlich and Stephanie O'Malley; (2) Preclinical studies on
naloxone: genetics and site of action, by Petri Hyytiä; (3) Clinical studies on
naltrexone for treating hazardous drinkers, by Dena Davidson; (4) Clinical studies on
naltrexone and
sertraline in the treatment of
alcohol dependence, by Conor Farren; and (5) Discussion by Janice D. Froehlich, Stephanie O'Malley, and Rainer Spanagel. Both preclinical and clinical studies are critical in the development of effective pharmacotherapeutic approaches for the treatment of
alcoholism. Nowhere has this been more evident than in the development of
naltrexone for the treatment of alcohol relapse. As research continues on the optimal use of
naltrexone for modifying alcohol intake, a number of factors have emerged that are likely to determine the efficacy of
naltrexone as a pharmacotherapeutic agent for the treatment of
alcoholism. Some of these factors include dose, frequency and
duration of treatment, pattern and severity of alcohol drinking prior to initiation of
naltrexone treatment, genetic aspects of responsive subpopulations, degree of alcohol craving, and susceptibility to adverse effects of
naltrexone. New, as well as established, animal models are being used to determine the parameters that optimize the ability of
naltrexone to modify alcohol drinking in acute and chronic alcohol access paradigms, under conditions of intermittent versus continuous alcohol intake, and in populations that vary in
genetic predisposition toward alcohol drinking. Current clinical studies are exploring the ability of
naltrexone to alter alcohol drinking when delivered in combination with pharmacotherapeutic agents that act on nonopioid transmitter systems and the difference in efficacy of
naltrexone when administered in populations that differ in drinking frequency and intensity, family history of
alcoholism, and alcohol craving. This symposium presented new research findings from both preclinical and clinical studies with the aim of facilitating the development of treatment regimens that optimize the therapeutic potential of
naltrexone in the treatment of
alcoholism.