Drugs Log

A new drug can help alcoholics overcome their addiction by reducing stress-induced cravings, a study has found.

There is already a drug on the market, Revia, which treats alcoholism by reducing the body’s ability to enjoy its effects.

This new drug cuts cravings by taking the edge off of stressful situations which might push recovering alcoholics to pick up the bottle again.

Behavioral stress is a major factor in extending the “vicious cycle” of alcoholism, said lead author Markus Heilig, clinical director of the National Institute on Alcohol Abuse and Alcoholism.

That’s because alcohol deprivation causes depression and increased sensitivity to stressful situations such as an argument with a spouse or tension at work.

“Alcohol is a particularly nasty drug because it actually makes you feel better, but it pushes you to feel worse once you’re without alcohol,” he told AFP.

The drug Heilig and his team tested targets an area of the brain, the neurokinin 1 receptor, which mediates responses to behavioral stress. It had previously been shown to reduce social anxiety but did not enter the market because results were inconsistent.

Helig and his team first tested its effectiveness on mice and then on a group of 50 alcoholics with anxiety problems who had been through detox and remained hospitalized for the four weeks of the trial.

Half were given a placebo and the other half were given the drug.

Cravings declined over time for all patients in the protected inpatient environment and were minimal in the majority of patients by the end of the study period.

However, those who had been drug showed a more marked improvement in the severity of their cravings when measured by self-reporting questionnaires, the assessment of their clinicians, and tests where they were exposed to socially stressful situations and then told to touch a bottle and smell their favorite alcohol.

Interestingly, there was no impact on anxious or depressive psychopathology which suggests that “the improvements observed might be specific for brain processes related to alcoholism,” the study published online in Science Express concluded.

The drug also led to increased brain responses to positive imagery and lessened responses to negative imagery, something which a recent study showed predicts less alcohol consumption over the next six months, tests using MRI mapping showed.

The next step is larger clinical trials to see if the drug can be of assistance to alcoholics who do not suffer from anxiety problems.

New Drug Suspected Capable of Treating Alcoholism

A study revealed that an existing pill might in aid in the curbing of a person’s appetite for alcohol, simply by reducing the cravings caused by stress.

The new drug reportedly worked by controlling the results of stress, as behavioral stress was a major contributor to the “vicious cycle” of alcoholism.

Study author Markus Heilig of the National Institute on Alcohol Abuse explained that depriving a person of alcohol would lead to depression and increased chances of succumbing to stress.

“Alcohol is a particularly nasty drug because it actually makes you feel better,” Heilig explained, as quoted by AFP, “but it pushes you to feel worse once you’re without alcohol.”

He continued that the drug would control a person’s responses to these effects of stress by targeting a particular part of the brain responsible for the reactions to stressful situations.

Pooling together a total of 50 recovering alcoholics, scientists gave the drug to 25 of them, and placebo pills to the other half.

Their experiment resulted in a 50 percent cut in the craving for alcohol for those who had been given the drug.

Heilig, a director at the National Institute on Alcohol Abuse and Alcoholism, noted that while other studies regarding alcoholism aimed to reduce the pleasure derived from alcohol, their study attempted to reduce the effects of the actual causes of alcoholism.

“It’s a fairly new approach to treating alcoholism treatment,” Heilig said, as quoted by ABC News. “We’re really trying to open up a new category of treatments that would help most people.”

The study received commendations from other scientists, calling it a significant discovery.

“This is a potentially important finding which indicates a novel mechanism for reducing craving in individuals who drink to reduce high anxiety,” said Boris Tabakoff, a professor and director at the University of Colorado and Denver.

Stress-Related Drug May Cut Alcoholics’ Cravings

New Research May Pave Way for New Alcoholism Treatment Therapies

A drug known to inhibit the stress response in the brain may also be a potential weapon against alcohol addiction.

So suggests a small study on recovering alcoholics published in the journal Science.

Researchers with the National Institutes of Health already knew that the drug in question neutralizes the action of a protein called NK1R (short for neurokinin-1 receptor), which is involved in the stress response in the brain. The first hint that the drug might be useful in cutting alcohol cravings surfaced when the investigators noticed that mice who didn’t have NK1R seemed to have less desire to consume alcohol.

To test their suspicions, the scientists gave the NK1R-blocking drug to 25 recovering alcoholics, while giving 25 others an ineffective placebo treatment. They found that those who received the drug reported about 50 percent fewer alcohol cravings.

Lead study investigator Dr. Markus Heilig, clinical director of the NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), says standard drug treatments to help curb drinking urges worked by reducing the pleasure that alcoholics get from drinking. This drug takes a different approach — reducing the anxiety that leads many alcoholics to reach for the bottle in the first place.

“It’s a fairly new approach to treating alcoholism treatment,” Heilig says. “We’re really trying to open up a new category of treatments that would help most people.”

Alcoholism experts not directly involved with the study say the finding offers tantalizing clues for new treatment — as well as hints to the connection between anxiety and drinking urges.

“This is a potentially important finding which indicates a novel mechanism for reducing craving in individuals who drink to reduce high anxiety,” says Boris Tabakoff, professor and chairman of pharmacology at the University of Colorado at Denver.

But even if the findings eventually lead to an effective drug treatment option for alcoholism, some experts say, there is no therapy yet that provides a sure-fire, one-size-fits-all solution to alcohol cravings.

“It may be that this medication would help alcoholics who drink when stressed,” says Dr. Charles O’Brien, vice chair of psychiatry and director of the Treatment Research Center for the University of Pennsylvania Health System. “It is wrong to think of all alcoholics as alike.”

A New Hope for Alcoholics?

Current drug treatments for alcoholism include naltrexone and disulfiram. And it has been shown that these medications offer help for some alcoholics. But Tabakoff says more options are needed.

“The current treatments, although producing statistically significant benefit, are still of modest utility,” Tabakoff says. “New approaches need to be introduced and tested. This represents one such novel treatment that seems to be particularly effective in reducing various measurements of craving.”

The need for another option in drug-based alcoholism treatment is underscored by the fact that the drug treatments that currently exist are each most effective for the relatively small subset of alcoholics who seem to be genetically predisposed to get an extra addictive kick from alcohol.

“Generally, these sorts of new drugs may help 20 percent of alcoholics or addicts initially quit drug use, though I am not sure they would work that well on maintaining abstinence,” says Steve Sussman, professor of preventive medicine and psychology at the University of Southern California.

“While this drug may be of assistance to the extreme users, I wonder about how well it would help the majority.”

Further Study Needed

Despite the apparent success in the human part of the trial, more research will be needed before such a treatment can be considered reliable and safe. For example, the possible interaction effects of the drug with alcohol, just in case users fall off the wagon, must be determined.

And since the new study involved only patients who were under hospital care, it remains to be seen how effective the drug could be in a real-world setting, where temptations for alcoholics abound.

Heilig says additional, broader trials are currently in the works. But even at this early stage, alcoholism experts say it’s possible that the most recent findings may be a sign that, at least for some alcoholics, more help could be on the way.

“The more types of treatment modalities available, the more people with addiction problems can be helped,” Sussman says.

Tabakoff agrees. “All of medicine is moving more and more towards personalized treatments that target subgroups of patients, and I believe this report is one example of that trend,” he says. “This may be an excellent option for a sub-group of alcoholics who also suffer symptoms of anxiety. Neither naltrexone nor disulfiram are focused on these subjects.”