Medications Can Aid Recovery from Alcoholism : Part 3

by Food and Drug Administration (FDA)

(Page 3 of 3)

A 1986 study found that Antabuse did not improve abstinence rates, length of time to relapse, or psychosocial functioning any more than counseling alone. But, patients on Antabuse who continued to drink drank less frequently than relapsed patients who did not receive the medication.

The second drug, ReVia (naltrexone), approved by FDA in December 1994 for treating alcoholism, acts on the opioid receptor in the brain to help prevent relapse and reduce alcohol cravings in those who drink. ReVia was developed by The DuPont Merck Pharmaceutical Co., which previously marketed naltrexone under the trade name Trexan for treating narcotic dependency. The drug remains available for treating narcotic dependency but under the new brand name, ReVia.

In a 12-week study of 70 alcoholic men, 23 percent of the ReVia-treated patients relapsed, compared with 54 percent of those receiving placebo. Of those who drank during the study, 50 percent of those on ReVia relapsed to heavy drinking, compared with 95 percent of those receiving placebo.

A study of 104 alcoholic men and women found that patients who took ReVia were about twice as successful in quitting drinking as patients who received placebo.

However, because ReVia was tested in conjunction with supportive therapy, FDA approved its use only as an adjunct to supportive therapy (such as group therapy) in treating alcoholism.

Studies show the drug is nonaddictive. But it can cause liver toxicity when given at doses higher than recommended. Therefore, it is not recommended for people with active hepatitis and other liver diseases.

NIAAA is sponsoring additional studies to determine which patients are best suited for treatment with ReVia, as well as what dose, therapy combinations, and treatment duration work best.

Research Continues

Though treatments are helping make controlling alcoholism easier, a cure is more elusive. The disease is so complex, said Richard Fuller, M.D., director of NIAAA's division of clinical and prevention research, that it may be unlikely one single drug to treat alcoholism will be discovered. Instead, he said, research will continue to focus on finding drugs that can treat various aspects of alcoholism.

"I really see alcoholism as a chronic relapsing disease, like arthritis," he said. "And just as with arthritis, in which various inflammatory agents can be used to treat an acute episode, there will be more drugs developed to help alcoholics get and stay on the road to recovery."

Current NIAAA research efforts focus on developing drugs to:

• induce sobriety in intoxicated patients
• treat long-lasting withdrawal symptoms, which often lead to relapse
• control alcohol craving
• improve mental abilities of patients with alcohol-induced mental damage
• decrease alcohol consumption by treating coexisting psychiatric disorders.

But the advent of these drugs is not likely to diminish the importance of behavioral therapies. Self-help programs, like AA, will continue to play an important role for many alcoholics.

One person who is a firm believer in such programs is AA member McCrory. "These people have been there," he said. "They tell it like it is: Alcoholism will never be cured, but there will be good days and good times if you stay sober."

Raw Oyster Risk for Alcoholics

Eating raw oysters can be dangerous for alcoholics (just as it can be for people with suppressed immune systems).

Raw oysters can carry the bacterium Vibrio vulnificus, which, if ingested, can cause serious illness — even death. This bacterium occurs naturally in marine waters and is often found in oysters from the Gulf of Mexico. People with liver disease, which is common among alcoholics, are 200 times more likely to die from this bacterium than those without liver disease.

According to the National Institute on Alcohol Abuse and Alcoholism, 90 to 100 percent of heavy drinkers show evidence of fatty liver, the earliest signs of liver disease. Ten to 30 percent develop alcoholic hepatitis, inflammation of the liver. And 10 to 20 percent develop cirrhosis, end-stage liver disease.

If you are unsure of your risk, check with your doctor. Or eat your oysters fully cooked because cooking kills all the bacteria.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.