Please select the eligibility criteria that correspond to the clinical trial below.
Title: Naltrexone and Cognitive-Behavioral Therapy for Patients With Alcoholism and Post-Traumatic Stress Disorder
Brief Summary: This study will evaluate naltrexone and cognitive-behavioral therapy treatments for alcohol dependence and post-traumatic stress disorder (PTSD). Subjects will be randomly assigned a 6-month treatment of either: 1) naltrexone alone, 2) naltrexone with PTSD psychosocial therapy, 3) a placebo with PTSD psychosocial therapy, or 4) placebo alone. An enhanced medication management intervention will accompany all treatment conditions. Follow-up assessments will be completed at 9 and 12 months after treatment.


Options:
A: Inclusion Criteria:

1. veteran status and VA healthcare eligibility,
2. a diagnosis of any alcohol or drug use disorder,
3. having completed an intake for outpatient SUD treatment at the VA Oakland outpatient mental health clinic, and
4. meeting criteria for a PTSD diagnosis based on a preliminary screen with the PC-PTSD and subsequent full clinical evaluation using the CAPS

Exclusion Criteria:

1. current participation in any day or inpatient mental health treatment,
2. any contraindications communicated by that patient's primary clinician,
3. acute psychosis, mania, dementia, or suicidal intent
B: Inclusion Criteria:

* Meets criteria for alcohol dependence and post-traumatic stress disorder.
* Heavy drinking in the past 30 days (an average of more than 12 alcohol drinks per week with at least 1 day of 4 or more drinks).
* Successfully complete medical detoxification.
* Exhibit clinically significant trauma-related symptoms.
* Live in a commutable distance to the University of Pennsylvania and agree to follow-up visits.
* Aged between 18 and 65 years old.
* Able to provide an informed consent.
* Speak and read English.

Exclusion Criteria:

* Current diagnosis of any substance dependence other than alcohol, nicotine, or cannabis.
* Evidence of opiate use in the past 30 days.
* Significant risk of violence or history of serious violent behavior during the past year.
* Continued contact with an intimate partner if assault by the partner is the index trauma.
* Changes in dosage or medication for any SSRI treatment in the three months prior to entering the study.
* Unstable or serious medical illness.
* Current severe psychiatric symptom.
* Mental retardation or another pervasive developmental disorder.
* Use of an investigational medication in the past 30 days.
* Pregnant, nursing or not using reliable contraception.
C: Inclusion Criteria:

1. At least 18 years old;
2. Actively enrolled in outpatient addiction services and meets criteria for substance use disorder;
3. Screened positive for PTSD (results of PCL show a likely Criterion A Traumatic Event and a score equal to or greater than 44);
4. Willing and able to provide informed consent to participate in the study;
5. Diagnosis of PTSD verified by the CAPS and total symptom score equal to or greater than 44;

Exclusion Criteria:

1. Acute psychotic symptoms (however, persons with a psychotic disorder are eligible if their symptoms are stable and they are well connected with appropriate mental health services);
2. Psychiatric hospitalization or suicide attempt in the past month (however, if the hospitalization or attempt was directly related to substance intoxication or detoxification and the person is currently stable, they are eligible);
3. Medical and/or legal situations are unstable such that ability to participate in the full duration of the study seems unlikely.
D: Inclusion Criteria:

* 18 years of age or older
* Fluent in English or Spanish
* Alcohol or drug dependent
* Heavy drinking in the past 30 days or recent drug use
* Provide 2 contacts to assist with follow-up
* Have no plans to move from the local area within a year of screening
* Score \>21 on Mini-Mental State Examination (no serious cognitive impairment)

Exclusion Criteria:

* Pregnant (self-report)
* Breath alcohol \>100 mg/dL
* Inability to provide informed consent determined by trained research associates

Answer: B