COMBINE Monograph Series
Medical Management Treatment Manual
A Clinical Research Guide for Medically Trained Clinicians Providing Pharmacotherapy as Part of the Treatment for Alcohol Dependence
Helen M. Pettinati, Ph.D.
Roger D. Weiss, M.D.
William R. Miller, Ph.D.
Dennis Donovan, Ph.D.
Denise B. Ernst, M.A.
Bruce J. Rounsaville, M.D.
COMBINE Monograph Series Editor
Margaret E. Mattson, Ph.D.
U.S. Department of Health and Human Services
National Institutes of Health
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane
Bethesda, MD 20892–9304
This manual was constructed, with permission, from several pre-existing manuals that included medical management as part of their interventions. These manuals are cited below. The Medical Management Subgroup (authors), with the assistance of Kelly Tobin Murray (University of North Carolina, COMBINE Coordinating Center), rewrote and edited sections to provide a focused, cohesive set of guidelines for medical practitioners to follow in delivering Medical Management (MM) treatment. We also acknowledge the individual contributions of Amy Schuhl and Carla Nappi (University of Pennsylvania), and Judith Arroyo, Ph.D. (University of New Mexico). We especially credit the MM clinicians from the COMBINE study, who generously provided the authors with feedback on all aspects of the MM treatment and use of the manual.
We received permission from the authors of the following manuals to use their materials in the construction of the Medical Management treatment manual.
Carroll, K.M., and O’Malley, S. Compliance Enhancement: A Manual for the Psychopharmacotherapy of Alcohol Dependence. Unpublished treatment manual, Yale University, 1996.
Fleming, M.; Zweben, A.; Barrett, D.; and Manwell, L. Brief Motivational Enhancement Therapy—Conducting BMET in a Combined Psychosocial and Pharmacotherapy Clinical Trial. Unpublished treatment manual, University of Wisconsin, 1997.
Mason, B.J., and Goodman, A.M. Brief Intervention and Medication Compliance Procedures—Therapist’s Manual. 1997. http://www.alcohol-free.com.
Volpicelli, J.R.; Pettinati, H.M.; McLellan, A.T.; and O’Brien, C.P. Combining Medication and Psychosocial Treatments for Addictions: The BRENDA Approach. New York: Guilford Press, 2001.
Noncopyrighted material appearing in this volume is in the public domain and may be reproduced or copied without permission from NIAAA or the authors. Citation of the source is appreciated. Recommended citation format is as follows:
Pettinati, H.M.; Weiss, R.D.; Miller, W.R.; Donovan, D.; Ernst, D.B.; and Rounsaville, B.J. COMBINE Monograph Series, Volume 2. Medical Management Treatment Manual: A Clinical Research Guide for Medically Trained Clinicians Providing Pharmacotherapy as Part of the Treatment for Alcohol Dependence. DHHS Publication No. (NIH) 04–5289. Bethesda, MD: NIAAA, 2004.
COMBINE (Combining Medications and Behavioral Interventions) was supported by grants under a collaborative agreement funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and implemented by 11 clinical research units and a data coordinating center.
Cooperative agreement awardee principal investigators, institutions, and grant numbers:
Raymond Anton, Medical University of South Carolina, U10–AA–11783
Dominic Ciraulo, Boston University, U10–AA–11715
Dennis Donovan, University of Washington, U10–AA–11799
James Hosking, University of North Carolina, U10–AA–11721
Bankole Johnson, University of Texas Health Science Center at San Antonio, U10–AA–11776
Richard Longabaugh, Brown University, U10–AA–11777
Barbara Mason, University of Miami, U10–AA–11727
William Miller, University of New Mexico, U10–AA–11716
Stephanie O’Malley, Yale University, U10–AA–11787
Helen Pettinati, University of Pennsylvania, U10–AA–11768
Robert Swift, Brown University, U10–AA–11777
Roger Weiss, McLean Hospital, U10–AA–11756
Allen Zweben, University of Wisconsin, U10–AA–11773
The contents of this manual are solely the responsibility of the authors and do not necessarily represent the official views of NIAAA or any other part of the National Institutes of Health.
DHHS Publication No. (NIH) 04–5289
Project COMBINE Monograph Series
The following publications are available from the National Institute on Alcohol Abuse and Alcoholism, Publications Distribution Center, P.O. Box 10686, Rockville, MD, 20849–0686.
Volume 1 Miller, W.R., ed. COMBINE Monograph Series, Volume 1. Combined Behavioral Intervention Manual: A Clinical Research Guide for Therapists Treating People With Alcohol Abuse and Dependence. DHHS Publication No. (NIH) 04–5288. Bethesda, MD: NIAAA, 2004.
Volume 2 Pettinati, H.M.; Weiss, R.D.; Miller, W.R.; Donovan, D.; Ernst, D.B.; and Rounsaville, B.J. COMBINE Monograph Series, Volume 2. Medical Management Treatment Manual: A Clinical Research Guide for Medically Trained Clinicians Providing Pharmacotherapy as Part of the Treatment for Alcohol Dependence. DHHS Publication No. (NIH) 04–5289. Bethesda, MD: NIAAA, 2004.
This document can be downloaded in its original graphic format—[PDF] | Ordering Information.
2. Initial MM Session (40 to 60 minutes)
3. Followup Sessions (15 to 25 minutes)
4. Medication Compliance and Treatment Session Attendance
5. Answers to Frequently Asked Medication Questions
6. Medical Attention
Appendix A Clinician Packet
Appendix C Patient Packet