New medical hope for alcoholics Two studies find naltrexone cuts the craving for alcohol

November 13, 1992|By Los Angeles Times

A medication called naltrexone promises to revolutionize the treatment of alcoholism, two groups of researchers have independently found. The drug is said to reduce an alcoholic's craving for liquor.

Use of the medication, in combination with conventional behavioral therapy, reduced relapses into alcoholism from the normal 50 percent of patients to only 20 percent, according to reports that are to appear tomorrow in the Archives of General Psychiatry.

The medication also made it easier for alcoholics who relapsed into drinking while on the program to return to abstinence, said psychiatrist Joseph Volpicelli of the University of Pennsylvania Medical Center.

The discovery could have immediate impact on alcoholism treatment because naltrexone already is widely available for use in treating narcotics addiction. Any physician is thus able to prescribe the drug for other purposes, such as treatment of alcohol abuse.

Government studies have shown that a minimum of 10.5 million Americans are victims of alcoholism, and many researchers believe that number significantly underestimates the problem.

At least 100,000 deaths are associated with alcohol abuse each year, either from cirrhosis of the liver or from accidents caused by intoxication.

But perhaps even more important are the social costs. Nearly half of all Americans have been exposed to alcoholism in their own families, according to a 1991 government report, and alcoholism is a major cause of divorce.

But few alcoholics -- no more than one in 10, according to Dr.

Volpicelli -- seek treatment for their addiction. And many who do seek treatment quickly drop out of programs, perhaps because the craving for liquor is so strong that they are unable to resist the temptation.

Current medical treatment -- as opposed to the traditional 12-step counseling programs exemplified by Alcoholics Anonymous -- relies on a medication called Antabuse. Patients who drink alcohol after taking Antabuse suffer severe nausea and vomiting. The drug serves as "a threat to the patient not to drink, but does nothing to reduce craving," said Dr. Enoch Gordis, director of the National Institute on Alcohol and Alcoholism.

Antabuse is a valuable medication for patients who are committed to stopping their drinking, he added, but is of little value for those who are not strongly motivated. Naltrexone is likely to be viewed as much more desirable by alcoholics because its effects are positive, reducing the craving, rather than negative.

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