Historically, based on this and other blinded trials, disulfiram developed a bad reputation as its detractors perhaps too hastily concluded that disulfiram was not any more effective than controls. But as we have shown, blinded experiments serve no purpose in their attempt to evaluate disulfiram efficacy. Control groups must not be led to believe that they have taken disulfiram so that differences in expectancies appear. Knowledge of disulfiram and its consequences are essential to its function. Disulfiram helps patients learn this new non drinking behavior, this ability to exercise self-control. As described by Brewer and Streel (2003), refraining from alcohol consumption is a learning process and requires intentionally becoming alcohol intolerant through exposure and response prevention [45]. In order to permit the learning phase to proceed despite various temptations, compliance was essential, hence the importance of supervision.
