Treatment of Skid-Row Alcoholics with Disulfiram

Abstract

As a potential method of treating Skid Row alcoholics appearing in the Atlanta Municipal Court, disulfiram (0. 5 g) was given daily to two groups: a volunteer group who were given their daily tablet by a family member, and a compulsory group, allowed to take disulfiram as an alternative to going to jail for public intoxication, who were given their daily tablet at the courthouse by a probation officer. The method of administering the disulfiram was that generally recommended in the literature but without a test dose of alcohol being given. In addition to the drug administration, the aid of various social agencies was mobilized to help break the cycle of repeated arrest for public intoxication. A minimal level of physical and mental health was required of the subjects, only those with a history of a myocardial infarction or overtly psychotic behavior being excluded; second, more than two-thirds of those taking the drug were doing so as an alternative to a jail sentence. Of the 64 volunteer patients, 32 were still abstinent at the end of the 9-month period of study (average length of abstinence, 3 months). Of the 20 Negro patients in this group, 14 were abstinent. Of the 132 compulsory patients, 61 were still taking the drug at the end of the 9-month period of study; of the 71 who were not, 17 had taken disulfiram daily for the duration of their suspended sentence but had not wished to continue. The results, obtained with a segment of the alcoholic population often considered the most refractory to treatment, suggest that disulfiram can help them maintain periods of abstinence which may provide an important key in breaking the "revolving door" pattern of the Skid-Row alcoholic. A small number of serious side effects were encountered in this group in which the level of physical fitness was very much below average. A high degree of success with Negro subjects suggests a significant difference in drinking patterns and attitudes toward treatment among whites and Negroes in the South which warrants further investigation.