Alcoholism: A new study finds that many drugs can help curb the urge to drink alcohol, but the researchers note that these medications are rarely ever prescribed.
Acamprosate (Campral) and naltrexone (Revia), along with help from groups such as Alcoholics Anonymous (AA) or psychological counseling, can be useful ways to help people stay away from alcohol, the review authors report.
“Most people with alcohol use disorders aren’t getting any treatment, and only about 10 percent are getting a medication as part of their treatment,” said lead researcher Dr. Daniel Jonas, an assistant professor of medicine at the University of North Carolina at Chapel Hill.
Two drugs can help with alcoholism, nalmefene (Selincro) and topiramate (Topamax) also can help patients stop drinking, he said. Nalmefene is approved for pain relief and topiramate is approved to prevent seizures, but they are also used “off-label” to treat alcohol abuse in patients.
Part of the big reason these medications aren’t used that much is that doctors aren’t sure these drugs work, Jonas said. “But we do have treatments that work, and we should be using them more than we are,” he added.
Jonas noted that the drugs really should be used along with other effective treatments.
“We don’t know if they should be used alone. They are always studied in conjunction with a psychological intervention, whether it’s AA or cognitive behavioral therapy. The standard of care is that everyone should do one of those things and then you would add medication,” he said. “When you add medication, you get added benefit.”
Dr. Katharine Bradley, an investigator at the Group Health Research Institute in Seattle and co-author of an accompanying journal editorial, said several medications are available to treat alcohol use disorders.
Unlike the old medications for alcohol abuse, these newest drugs don’t make people ill if they drink, Bradley explained.
“Instead, newer effective medications for alcohol use disorders address the underlying biology of addiction to alcohol, and make people less likely to drink or less likely to drink heavily if they do drink,” she said.
Patients fighting alcoholism should ask for information about medications that could help them in their battle, Bradley said.
“The decision of which alcohol treatment to choose should be the result of discussions between patients and their clinicians that take into account patient values, preferences and goals,” she said.
For the new review, Jonas’ team reviewed 122 studies that evaluated acamprosate, naltrexone or both drugs. The researchers also calculated the number of people who would have to be treated with a drug to see the benefit in a single patient.
Researchers found that 12 patients would be given acamprosate to see a benefit from the drug in one patient. For naltrexone, it would be at least 20 patients.
There haven’t been any head-to-head trials to see if one drug is more effective than the other, Jonas said.
For naltrexone, the researchers didn’t find an association with return to some drinking or even heavy drinking, but they did find an association with reduction in the number of heavy drinking days.
Alcoholism can cause damage to the liver, brain and many other organs and may increase the odds of dying early threefold, the researchers said.
Journal of the American Medical Association. The U.S. Agency for Healthcare Research and Quality funded the research.
STUDY: New Medications Can Effectively Help People With Alcoholism.