Evaluation of an Aversive Technique as a Treatment for Alcoholism; Controlled Trial with Succinylcholine-Induced Apnea

In an attempt to produce an aversive response to alcohol with succinylcholine, 25 volunteer alcoholics at the Iowa City Psychopathic Hospital were each placed in a semireclining position with a hypodermic needle placed into an arm vein, with saline drip attached. Each patient was handed a glass containing an alcoholic beverage and asked to hold it, look at it, smell it and hand it back. This was repeated 4 times at 1-minute intervals. On the fourth occasion, the patient was asked to taste the drink and 10 mg of succinylcholine was injected through the needle. Apnea followed within seconds of tasting the beverage. The patients (Group A) were then discharged from the hospital, having received no other treatment for their alcoholism, and their status compared with 3 control groups: Group B, 17 alcoholics who went through the same procedure as Group A but received saline instead of succinylcholine; Group C, 59 alcoholics who had received the regular hospital treatment of individual, group and drug therapy; and Group D, 22 alcoholics who had been seen and evaluated at the hospital but had refused treatment. One year later 88% of Group A, 70% of Group B, 66% of Group C and 45% of Group D showed substantial increases in abstinence (3 to 12 months) as compared with the previous year. The differences between Groups A, C (p<.05) and D (p<.01) were significant, but not between Groups A and B. The mean change in number of months abstinent increased in all groups, with Group A (7.4 months) significantly greater than Group C (4.6 months, p<.05) and Group D (2.2 months, p<.01) but not significantly greater than Group B (5.4 months). To determine the relationship between abstinence and social adjustment, four indices of social adjustment (illness, court convictions, employment and social relations) were applied to Groups A and B, and revealed a definite trend toward increased social competence with increased abstinence. Marital status was related to abstinence: of the 25 married patients in Groups A and B 22 showed improvement, compared with 12 of the unmarried.