Anti-relapse drug: Hope for alcohol addicts

Health & Fitness

October 24, 2004|By Mary Beth Regan | Mary Beth Regan,Special to the Sun

A drug expected on pharmacy shelves by January offers hope for millions of alcoholics in this country and could help remove the stigma attached to the disease, doctors say.

A New York company, Forest Laboratories Inc., will market the prescription drug for pharmaceutical giant Merck & Co., under the brand name Campral in early 2005, company officials say.

The move is significant because it marks the first time in a decade that a new drug has been approved by the Food and Drug Administration for use in the United States to battle alcoholism. The drug, acamprosate, is used after a person has stopped drinking, and has been available in Europe for about 15 years.

Researchers say acamprosate is a scientific breakthrough because it is the first anti-relapse medication that works to normalize alcohol-induced changes in brain functions of alcoholics after they stop drinking. People will take the drug for up to a year after they abstain from alcohol.

"This is the first drug we have for alcoholism that acts as antidepressants do for depression," says Barbara Mason, professor and co-director of the Pearson Center for Alcoholism and Addiction Research at the Scripps Research Institute in La Jolla, Calif.

Addiction specialists hope the drug will help change the public perception of alcoholism as a behavior problem, in much the same way that antidepressants have helped illuminate the biological underpinnings of mental illness.

"It used to be that people who were depressed were told to shape up," says Dr. Elisabeth Houtsmuller, assistant professor of behavioral biology at Johns Hopkins School of Medicine, who studied the interaction between acamprosate and alcohol. "But with effective anti-depression medications on the market, it's become more acceptable to get medical help.

"My hope is that we will see the treatment of alcoholism follow the same path," Houtsmuller adds.

Abuse on the rise

The number of American adults who either abuse alcohol or are alcohol dependent continues to rise, according to the National Institute on Alcohol Abuse and Alcoholism. In 2001-2002, for example, the number of problem drinkers and alcoholics hit 17.6 million, or 8.5 percent of the adult population, up from 13.8 million people, or 7.4 percent of the population a decade earlier, NIAA says.

The organization defines alcohol abusers as those whose drinking causes them to "fail to fulfill major role obligations" such as showing up for work. Alcohol dependency is defined as a condition in which a person cannot control his or her drinking and exhibits withdrawal signs if drinking is stopped.

Alcohol abuse kills roughly 75,000 Americans each year, and shortens the lives of drinkers by about 30 years, according to another government study.

Dr. Eric Weintraub, director of Alcohol and Drug Abuse at the University of Maryland School of Medicine, says the medical community has long understood alcoholism to be a disease process. "But trying to sell that to the public isn't easy," he says. "A lot of people still consider it a character issue.

"They think the alcoholics or addicts are out there having a good time," he says, "But I can tell you most addicts are miserable. They are homeless, they are estranged from family. ... They aren't having a good time. And they would do anything to stop drinking."

Limited options

Doctors have had few drugs at their disposal to aid people trying to abstain from alcohol. One drug, Antabuse, has been on the market since 1948. It acts to discourage alcohol consumption by making people ill if they drink.

But it's risky to prescribe, Weintraub says, because you need to know that the patient isn't going to continue drinking. "This drug can make people violently ill," he says.

Also, if alcoholics want to resume drinking, they simply stop taking the drug and wait a few days before starting again.

Another drug, ReVia, containing the compound naltrexone, has been available since 1994. It acts on opioid receptors in the brain to help reduce the pleasurable aspects of drinking. Studies have shown that it helped reduce heavy drinking in some patients, especially men.

Mason, of the Scripps Research Institute and a principal investigator of acamprosate, says she is encouraged because the new drug addresses some of the biological changes that occur in a person's brain when they become dependent on alcohol and then stop drinking.

While the drug doesn't stop people from drinking, studies show it helps brain systems affected by alcohol use return to normal functioning after alcohol withdrawal.

"But this is not Tinkerbell's wand," Mason warns. "It's not a drug that a wife can slip into her husband's coffee in the morning and he'll never have another drink."

An individual must stop drinking first and seek treatment from a doctor. Doctors then can prescribe Campral if the drug is used with traditional psychosocial treatments such as alcohol counseling or support groups.

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