Collins SE, Duncan MH, Saxon AJ, et al. - This randomized clinical trial was undertaken in Seattle, WA to investigate whether combined pharmacological and behavioral harm-reduction treatment for alcohol use disorder (HaRT-A) would be efficacious in individuals experiencing homelessness and alcohol use disorder. Eligibility criteria were applied for inclusion of participants (aged 21–65 years), who were then randomized 1:1:1:1 to either HaRT-A plus intramuscular injections of 380 mg extended-release naltrexone (XR-NTX; HaRT-A plus XR-NTX group); HaRT-A plus placebo injection (HaRT-A plus placebo group); HaRT-A alone (HaRT-A alone group); or community-based supportive services as usual. Findings during the 12-week treatment period showed that reduced alcohol use and alcohol-related harm as well as improved physical health-related quality of life were conferred by combined pharmacological and behavioral harm-reduction treatment vs existing services in this population. Positive results for behavioral harm-reduction treatment alone were also found, though they were not as consistent. In view of non-significant disparities between those receiving HaRT-A plus placebo and HaRT-A plus XR-NTX, the integrated pharmacological and behavioral treatment impact cannot be due to XR-NTX alone.