This study will assess the ability of naltrexone (Revia) to reduce the risk of relapse in Alaska natives with alcohol dependence. The study will also examine whether a combination of naltrexone and sertraline (Zoloft) yields better abstinence rates than naltrexone used alone. Alaska Native individuals will be recruited into a 16 week outpatient study.

• Alcoholism
• Alcohol Dependence

• Drug: sertraline
• Drug: naltrexone

• Experimental: Naltrexone plus Sertraline
• Experimental: Naltrexone alone

Inclusion Criteria:

• Alaska Native having biological Alaska Native ancestry.
• Meets criteria for alcohol dependence.
• Prior to entering the study must be abstinent between 3 and 14 days and have a withdrawal assessment.
• Stable residence to ensure that subjects can be located during the study.

Exclusion Criteria:

• Currently meets criteria for abuse or dependence on substances other than alcohol or nicotine.
• Current use of disulfiram.
• Psychotic or otherwise severely psychiatrically disabled.
• Use of other psychotropic medications including antidepressants and anxiolytics.
• Medical conditions that would not permit the use of sertraline or naltrexone, such as a history of unstable or severe hepatic, cardiovascular, metabolic, endocrine, gastrointestinal or kidney disease.
• Hepatocellular disease or elevated bilirubin levels.
• Females who are pregnant, nursing, or not using a reliable method of birth control.
• Probation or parole requirements that might interfere with participation in the study.
• Involvement in alcohol treatment other than provided by the study or AA.
• Use of monoamine oxidase inhibitors in the past month.
• Current use of Type 1C antiarrhythmics propafenone and flecainide.