The present work focuses on open-label trials to correct the dilutive and misleading effect that blinded trials have had on the question of disulfiram efficacy. In formulating the hypothesis that only open trials can determine disulfiram efficacy, this meta-analysis addresses a cardinal methodological flaw that was not considered in a previous meta-analysis. Disulfiram was shown to be more effective than controls in supervised than non supervised RCTs. Based on a larger sample than a previous meta-analysis [19], adding eleven studies (887 subjects), it broadens the evaluation of disulfiram efficacy to include alcoholics with concomitant cocaine abuse or dependence. In addition, it offers a meta-analytic evaluation of the safety of disulfiram, a poignant issue to this day.
