Medications To Treat Alcoholism
While it’s not talked about much, there are actually medications available that can aid patients in the treatment of alcoholism. What’s surprising is how few people, including medical professionals, know about them.
The Journal of American Medicine Association (JAMA) released a paper earlier this year, which analyzed more than a 120 research studies.
All of these studies focused on the benefits of Pharmacotherapy, or prescription medication, in the treatment of alcoholism. The majority of them looked at two medications, Naltrexone (Vivitrol) and Acamprosate (Campral).
Both medications, according to the JAMA paper, made alcoholics less likely to drink, and when they did relapse, the meds decreased the amount of days in which they drank. The data shows that these drug therapies can be very powerful tools.
A brief discussion about agonist and antagonist medication is warranted here. Simply put, a medication that is an agonist creates an effect, whereas antagonist medications block an effect.
- Agonist medications attach themselves to receptors in the brain and mimic a similar drug’s effect. For instance, methadone is an opioid agonist used in the treatment of heroin addiction.
- Antagonist medications also attach to receptors in the brain, but they block an addictive drug from being able to interact with the brain’s receptors and get a user “high.” Naltrexone is an antagonist drug used in the treatment of alcoholism.
Why Don’t More People Use These Medications?
Statistically, only about a third of the 23 million Americans who need treatment for alcoholism or drug addiction ever receive it. Furthermore, the JAMA paper reports that out of the relatively few people who actually get treatment, only 10 percent are prescribed these medications, which can help them.
“Patients with Alcohol Use Disorder (AUD) receive poorer-quality care than patients with any other common chronic conditions…and medications for AUD are particularly under utilized,” states an editorial essay accompanying the JAMA paper.
One of the reasons, some experts believe, that naltrexone and acamprosate aren’t widely prescribed is because they’re generic products. Sadly, this reduces financial incentives for pharmaceutical companies to market them.
Dr. Raye Litten, of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in a comment to CNN Health, said, “Many primary care physicians just don’t know about this.”
Naltrexone is an antagonist, and blocks receptors in the brain believed to interact with alcohol and provide feelings of pleasure.
Acamprosate, on the other hand, interacts with chemicals in the brain that are associated with a sense of anxiety or panic about withdrawal in the absence of alcohol. Naltrexone is taken once a day, and acamprosate is two pills, taken three times a day.
There are some limitations. For instance, anyone with kidney problems cannot take acamprosate, and naltrexone is hazardous to anyone with liver damage. It’s also important to note that each person reacts differently to these medications.
While both drugs show positive results, neither is a total cure. The JAMA paper makes it clear that nearly all of the 22,000 patients included in this combined study received some form of addiction treatment, counseling or attended self-help groups along with taking meds.
Dr. George Koob, a director at the NIAAA, summed up the general consensus by saying, “In the long term, most people need some kind of behavioral intervention, whether it’s group therapy or individual therapy or mindfulness…but I think medications help you along the way.”
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