Go To Health – New Treatments for Alcohol Addiction
Doctors and nurses often use the following screening questions to find and help people with alcohol addiction:
*Have you ever felt you should cut down on your drinking?
*Have people annoyed you by criticizing your drinking?
*Have you ever felt bad or guilty about your drinking?
*Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
Answering yes to 2 or more of these questions indicates a strong possibility of problem drinking. Some reports say that 8% of the population has serious problems with alcohol, and most do not get treatment.
AA is a highly effective treatment for many people. It replaces drinking friends with the fellowship of AA members and sponsors who support sobriety and teach important coping skills. Many members consider that the 12 steps are a guide to a new way of life. Alcoholics who use drug treatments would do well to go to AA as well, for ongoing social support.
Antabuse is a drug that makes people seriously ill if they drink. As long as it is taken it is a deterrent, but it has a mixed record because it does not reduce the craving for alcohol, nor does it treat alcohol withdrawal symptoms. It is more widely used and more successful in Europe, with abstinence rates of 50%
Naltrexone, is used to decrease cravings for alcohol. Alcohol increases the release of brain opioids, compounds that promote a sense of pleasure. Naltrexone, an opioid antagonist, blocks brain receptors for these opioids, making it easier for drinkers to remain abstinent or stop quickly in the event of a slip. Naltrexone can reduce relapse and craving for alcohol in many but not all people. It is also used in treating opiate addiction (heroin, oxycontin, et al.) and smoking. This is important, as heroin use is rising. A monthly injection of Naltrexone has been found to work better than a daily pill, at a lower overall dose. It should not be used if a person has hepatitis or cirrhosis.
Baclofen is prescribed as a muscle relaxant, and has been found to reduce cravings for alcohol. Its structure is similar to a brain neurotransmitter known as GABA, which lowers excitability and relaxes muscle tone. It decreases craving for alcohol, is helpful in withdrawal, and can be used by people with cirrhosis. Baclofen use has been popularized by Olivier Ameisen, an academic cardiologist who wrote ‘The End of My Addiction’. He recounts his recovery from being a serious alcoholic with the use of Baclofen. Trials are also underway to treat cocaine addiction with this drug.
Campral is a new drug that seems to restore chemical balance in the brain after people stop drinking; It does not help with withdrawal symptoms, but may reduce sleep disturbances. It should not be used by depressed people, who may become a suicide risk.
Genetic differences may explain why these 3 drugs are helpful for some but not all. (Pregnant and breast-feeding women should not use them.) Considering the huge personal and social dangers of alcohol abuse, they are important new medications
Sadja Greenwood. MD