Over 17 million adults in the US suffering from Alcohol Use Disorder (AUD) and 88,000 deaths a year from alcohol abuse or excessive alcohol use. It is surprising that many people do not know there are medications available to help manage this disease. Like any chronic disease getting treatment helps.
“Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.”
– National Institute on Alcohol Abuse and Alcoholism
There are currently three medicines available to treat AUD. They are important to learn because they can give those suffering from AUD an advantage and help prevent a relapse.
Antabuse was first discovered in the 1920’s by Danish researchers. They tested the drug on themselves to see if it would be a possible anti-parasitic cure. They went out to the local pub after work and found that drinking just a small amount of alcohol caused them to be violently ill. Their cure for parasites was used to develop a cure for AUD. For the past 60 years, it has been sold under the name Antabuse. It inhibits the enzyme acetaldehyde dehydrogenase that is needed by the body to process alcohol. When this enzyme is absent and alcohol is present in any amount, the person will suffer all the effects of a hangover immediately including: extreme vomiting, sweating, thirst, weakness, blurred vision, and many other serious side effects. The idea is that the user will avoid any alcohol use to avoid the effects caused by using it while on Disulfiram. Total abstinence is necessary while using this medication.
ReVia was approved in 1984 as a treatment for heroin and in 1995 for use in treating AUD. It is available in pill form or as an extended-release injectable. In pill form, it is sold as ReVia or Depade and is taken once per day. Naltrexone binds and blocks opioid receptors in the brain and makes the use of alcohol far less rewarding. A person may drink alcohol, but he or she will not get high when taking Naltrexone daily. Naltrexone is not addictive nor does it react adversely with alcohol. A person may relapse while using Naltrexene and can continue using it without any ill effects, unlike Antabuse. Long-term Naltrexone therapy extending beyond three months is considered most effective, but therapy may also be used indefinitely.
Sold under the trade name Campral® Delayed-Release Tablets, this drug was approved for use in 2004 by FDA. It’s one of the newest medications to be used to treat AUD. Acamprosate has been used for nearly 20 years in Europe, where it has been found to be safe and effective for treating alcohol dependence. It works by helping to balance out the neuro transmitter systems in the brain of someone who suffers from alcohol dependence. The neuro transmitter systems have become accustomed to alcohol being present and cannot function properly when it is absent. Acamprosate helps to normalize the brain’s activity and makes it easier to maintain abstinence. People who relapse may benefit from continued use. There are no ill effects from combining Acamprosate and alcohol.
All the above medications are non-addictive and pose no threat for abuse. These medicines are designed to help manage a chronic disease, just as someone might take drugs to keep their asthma or diabetes in check. According to National Institute on Alcohol Abuse and Alcoholism “Research shows that about one-third of people who are treated for alcohol problems have no further symptoms 1 year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.”
Historically, treatment for AUD was relegated to support groups such as Alcoholic Anonymous, but since it has been categorized as a chronic brain disease by the American Society of Addiction Medicine more doctors view AUD as a chronic illness and that should be treated as such.
These medicines and others being developed may help a large portion of the population with AUD to recover from a disease they never asked for.
Information sourced from:
- U.S. Department of Health and Human Services
- Substance Abuse and Mental Health Services Administration
- Center for Substance Abuse Treatment
- National Institute on Drug Abuse
- National Institute on Alcohol Abuse and Alcoholism