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The winds of change have pushed the treatment of alcoholism a few steps forward. Last month the Food and Drug Administration (FDA) ruled that drugs used in the treatment of alcohol use disorder can be approved if they’re shown to reduce a patient’s drinking rather than resulting in complete abstinence. Physicians will now be able to prescribe these drugs in tandem with alcohol treatment program.
This is good news for estimated 17 million Americans suffering from alcoholism. Previously, the benchmark for approval of these drugs had been total sobriety. Researchers, though, often lamented that total abstinence from alcohol is unattainable in a clinical trial setting. The new guidelines will open the door for scientists to explore, and hopefully, create more effective drugs.
Eric Pahon, an FDA spokesman wrote, “While total abstinence from alcohol is desirable, reducing heavy drinking to within ‘low-risk’ daily limits presents an alternative goal in drug development so more treatments may be developed.”
What are the Drugs the FDA has Approved for Treating Alcoholism?
Some of the current FDA approved drugs used in the treatment of alcoholism are:
Naltrexone – restricts the amount of the dopamine that receptors in the brain create in response to alcohol. This helps to limit alcohol cravings. Naltrexone is often prescribed for patients just out of detox and can reduce relapse rates in the first three months of sobriety.
Acamprosate – stabilizes chemical imbalances in the brains of alcoholic patients and can help in preventing relapse. It has also been shown reduce anxiety and mood swings, and improve sleep during alcohol withdrawal.
Antabuse – used as a deterrent to drinking because of the negative physical side effects when mixed with alcohol.
Both Naltrexone and Acamprosate are antagonist therapies. This means the drugs bind to opiate receptors in the brain, and work against the euphoric effects of addictive substances such as alcohol and heroin. Antabuse is considered more aversion therapy.
What About Relapse?
More often than not, the general public views a relapsing alcoholic as someone with a weak will or lacking in character. The truth of the matter is that addiction is a chronic illness, and relapse is simply a recurrence of the disease’s symptoms. Some estimates put the rate of relapse among alcoholics at 90 percent. It’s considered a normal part of the recovery process.
While lifelong sobriety is the goal, the focus should also be on minimizing the occurrence and severity of relapse and increasing quality of life. A better understanding of what causes a recovering alcoholic to revert to old behavior can reduce the stigma associated with these episodes and help patients live a healthier, sober lifestyle.
In light of the new guidelines, the National Institute on Alcohol Abuse and Alcoholism is already engaged in a new clinical trial with the drug Horizant. It’s currently prescribed for restless-leg syndrome, but scientists believe it might be another effective tool in the treatment of alcoholism.
By loosening the constraints on scientists and pharmaceutical companies, the FDA is making it possible for physicians and their patients to broaden their approach to achieving total sobriety. The new guidelines by the FDA don’t change the definition or prognosis of alcohol use disorder, but they open the door for the discovery of new drugs that may aid in successful recovery.