Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Medication helps alcoholics control drinking

18.02.2005


A little-known drug called naltrexone provides a “meaningful benefit” in helping alcoholics moderate their drinking, according to the latest review of evidence from 29 studies on four continents.



The findings, along with the recent FDA approval of a similar drug called acamprosate, open the door to new treatment options for drinkers who aren’t yet ready to face total abstinence. Naltrexone, which is not addictive, “should be accepted as a short-term treatment for alcoholism,” say authors Dr. Manit Srisurapanont and Dr. Ngamwong Jarusuraisin of Thailand’s Chiang Mai University. Almost all of the studies tested naltrexone, or NTX, in combination with psychosocial treatments such as counseling or self-help groups, and the authors recommend using this approach in everyday practice.

The review’s conclusions are based on “high-quality evidence” that naltrexone reduces by 36 percent the risk of an alcoholic relapsing to heavy drinking in the first three months of recovery. “Short-term treatment of NTX for alcoholism gives a meaningful benefit in preventing a relapse,” the review said, citing an 18 percent lower likelihood that patients will abandon their treatment program. The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.


Dr. Joseph Volpicelli, of the University of Pennsylvania School of Medicine, has been conducting research on naltrexone use for alcohol dependence since the early 1980s. Naltrexone blocks the brain’s receptors for natural painkillers, known as opioids, which normally create the feeling of wellbeing associated with drinking. He explains that the benefits of naltrexone lie not so much in preventing a patient from having one drink, but rather in breaking the cycle where one drink leads to many more. “Naltrexone helps people have more control over the use of alcohol. For me, that’s the fundamental issue of what addiction is: impaired control.”

However, this approach requires a substantial change from the abstinence-only philosophy that goes back at least as far as Prohibition. Naltrexone is most effective, says Volpicelli, in a treatment program “designed to support the notion that while one drink is not great, what you really want to stop is excessive drinking.” While few professionals advise people with alcoholism to abandon the ultimate goal of total abstinence, Volpicelli argues that about 20 million Americans suffer from alcohol abuse disorders, yet only about 2 million are in any kind of treatment program. “We should be flexible enough to get at that 90 percent of people who aren’t in treatment,” he says.

The U.S. Substance Abuse and Mental Health Services Administration agrees in its naltrexone treatment protocol, saying, “Abstinence should be a desired goal for the patient; however, reductions in drinking may be an acceptable intermediate outcome … because there are many other areas of a patient’s life that can improve, such as job performance, social relationships, and general physical health.”

Although naltrexone (ReVia) has been available for more than 10 years, Volpicelli says it has been poorly marketed, and most patients and primary care doctors remain unaware of its potential. That may change now that the manufacturer of acamprosate (Campral) has embarked on a campaign to promote pharmacological treatment of alcohol addiction.

Review author Srisurapanont notes that the availability of both medicines now gives patients an alternative if one is not effective for them. And, he adds, the possible benefits of using the medications in combination should be studied. The review also notes that other areas ripe for future study include the possible benefit of continuing naltrexone treatment beyond the first three months of recovery and strategies to further increase treatment completion.

Volpicelli believes psychiatry is on the brink of recognizing a new standard of care for alcohol abuse disorders: allowing patients to choose from a variety of treatments, which may or many not focus on total abstinence. It is, he believes, a time of great hope. To those who suffer with alcoholism, he says, “Be aware of all the options available and find the best one for you. See someone, stay in treatment, and over time you’re going to get better.”

1. Srisurapanont M, Jarusuraisin N. Opioid Antagonists for Alcohol Dependence (Review). The Cochrane Database of Systematic Reviews 2005, Issue 1

Manit Srisurapanont | EurekAlert!
Further information:
http://www.hbns.org

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Contacting the molecular world through graphene nanoribbons

19.02.2018 | Materials Sciences

When Proteins Shake Hands

19.02.2018 | Materials Sciences

Cells communicate in a dynamic code

19.02.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>