Despite its apparent success with compliant or supervised alcohol dependent patients, efficacy studies of disulfiram have been all but concordant, leading to confusion and debates that are largely based on poorly designed studies. The principal methodological design flaws are failure to monitor compliance, absence of control groups, unmatched control groups, no clear objective measure of abstinence, and the problem of blinding in disulfiram studies [2], [17], [18]. The use of double-blind studies has long been considered the standard method of determining drug efficacy. The principal advantages of the blinding procedure are to minimize the effects of disulfiram biases such as perceptions and expectations arising from both patients and researchers about the drug's effects. Disulfiram, however, unlike other medications, is problematic in blind trials for two main reasons. First, the expectation of a DER in the disulfiram treated patients is thought to be directly related to the efficacy of the drug and thus the disulfiram group must be open to their treatment in order to maintain these expectancies. Likewise, the control group(s) must be open to their treatment in order to
