There is a medication available for treatment of alcoholism and studies show that it works with those people who have alcoholism in their family and have cravings for alcohol. There are limited medication treatments available for those with a dependence on alcohol and the drug Naltrexone is very effective however it does not work for everyone. Marco Leyton, with McGill University, says this is one of the "few medications approved for treating alcoholism". The results of the study were published in a Science Daily report and show that a large percentage of those battling alcoholism who received stimulation from the drug while drinking alcohol experience "good feelings" such as elation.

Naltrexone works on opioid receptors and because it is specific to those receptors it produces feelings such as exhilaration. Although this certainly isn’t a cure for the disease, the drug may make the person more receptive to treatment and more likely to drink smaller amounts, says Charles P. O’Brien, with the Dept. of Psychiatry at the University of Pennsylvania. The medications’ effectiveness may depend on several factors including genetics and gender because of the gene related to the body’s biological "endorphin" system. Leyton and colleagues tested 40 social drinkers, 20 women and 20 men ranging in age from 18 to 50 years old for a period of six days.

Both O’Brien and Leyton agreed that the findings of the study should be used to tailor options for treatment of those individuals dependent on alcohol and Leyton believes if clinicians and researchers collaborate, they can make it easy to predict those who will benefit most from one treatment compared to another in advance. Leyton hopes to identify the "biomarkers" for a more personal approach to specifying medicinal needs of those with alcohol dependence.

A new study looks at the extent to which motivation and resisting temptation change during alcohol addiction treatment, and the degree to which these variables affected drinking behaviors.The researchers found that differences in motivation seem to make a significant difference in seeking, complying with, and completing alcohol addiction treatment. This suggests that treatments tailored to specific subgroups may be more effective.

J. Kim Penberthy, corresponding author of the study and associate professor of psychiatry and neurobehavioral sciences at the University of Virginia School of Medicine, said that the researchers decided to focus on motivation in the form of stages of change and self-efficacy, such as resisting temptation and abstaining from alcohol.

For example, people who are preparing to enter treatment have completed early tasks such as overcoming ambivalence, decision making, and committing to a plan, and are therefore more motivated to change their behavior by reducing their drinking before starting treatment.

People who have a strong belief in their ability to resist temptation to drinking are more confident and think about tempting situations differently, which increases their motivation to complete treatment and prevent relapse.

Penberthy added that patient motivation and self-efficacy are important in terms of which patients respond to treatment and when. For the study, the researchers looked at changes in motivation, temptation to drink, confidence to abstain, and drinking behaviors during the treatment phase of a study of 321 alcohol-dependent individuals.

Participants were given cognitive behavioral therapy (CBT) and either the anti-craving medication ondansetron or a placebo. The researchers also looked at the ways in which individual variables such as drinking severity, age of onset of alcohol dependence, and medication status influenced changes in motivation, drinking behaviors, and self-efficacy.

Penberthy said that increased motivation to change, reduced temptation to drink, and increased confidence to abstain predicted reductions in drinking regardless of the treatment provided, which indicates that tailoring treatment plans to target certain subgroups may be most effective.

The study found that ondansetron was more effective in early-onset drinkers in reducing drinking behaviors, compared to late-onset drinkers. It also helped increase the percentage of days abstinent and decreased the temptation to drink in early-onset drinkers. The drug did not have a different impact on early-onset versus late-onset drinkers in terms of increased motivation or confidence to abstain.

Reductions in drinking behavior in early-onset drinkers may be helped along by a reduced temptation to drink, Penberthy said. This supports the idea that early-onset alcohol dependence is a biologically based disease and is more responsive to selective serotonergic agents to reduce the temptation to drink, which leads to decreased drinking behavior.

The authors added that they need to focus their research and clinical work on tailoring treatment methods based on the stage of the disease, as well as the patient’s level of motivation, self-efficacy, and biological response to medications.

Penberthy added that this current study is the first step in understanding more about which patients respond to treatment and the mechanisms that may be involved in the changes in drinking behavior, and that this knowledge is necessary to tailor treatments to alcohol-dependent individuals.

Source: Science Daily, Motivation to Change, Confidence to Resist Temptation, Should Tailor Alcohol-Dependence Treatment, June 15, 2011

Many strategies have been used to deter alcohol consumption, from the AA 12-step program to therapy and hypnotism. There are medicinal methods used as well, and the extract of the kudzu root has been utilized in China as a common remedy to excessive alcohol use.

The specific mechanisms employed by the kudzu root are unknown, but it has long been used to reduce alcohol abuse. It has not been effective in eliminating alcohol consumption, but in hopes of using the root extract to treat alcohol consumption and even dependence, a recent study sought to investigate its effects on participants.

The study is expected to be published in the April 2011 issue of Alcoholism: Clinical & Experimental Research. Lead author David M. Penetar, assistant Professor of Psychology in the Department of Psychiatry at McLean Hospital and colleagues examined the way kudzu root extract worked as a pre-treatment for alcohol consumption.

Though there has not previously been conclusive evidence discovered about how kudzu works, one possibility is that isoflavones, biologically active molecules affecting physiology, affect the effects of the alcohol. Previous recent studies had shown that animals treated with kudzu root demonstrated a reduction in alcohol consumption.

The researchers recruited 12 men and women to participate in a double-blind placebo-controlled test. The participants were treated with either the kudzu or a placebo for nine days, and then received an alcohol challenge to determine whether the kudzu had any effect on consumption and related symptoms.

The results of the study showed that there was little to no effect on alcohol symptoms related to behavioral, physical or cognitive performance. The researchers found, however, that there was exhibited in the participants an increase in heart rate, skin temperature and blood ethanol levels.

The researchers believe that the effect on blood ethanol levels may result in a delay in subsequent drinks after consuming the first alcoholic drink. A rapid rise in blood alcohol level, said Penetar, requires additional research using fMRI technology to determine whether kudzu affects regional blood flow.

The results have led to speculation about how the kudzu’s effects on blood ethanol level might affect alcoholism abuse behaviors. It is possible that people achieve the desired effects of alcohol with fewer drinks and therefore curb alcohol intake. However, more research is required to understand whether the results of this study can be confirmed to show that the kudzu root is responsible for reduced alcohol consumption.

The integration of alcohol screening, treatment, and referral into primary care and other medical settings is not routinely done. In addition, there are no current studies evaluating the effectiveness of integrating care for alcohol use disorders (AUDs) into routine treatment for tuberculosis (TB), despite the high co-occurrence and mortality associated with these two diseases.

In response, researchers have designed a trial study to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine care for TB. The study will be published in the February 2010 issue of Alcoholism: Clinical & Experimental Research.

"In many primary-care settings, screening for drinking problems is not necessarily a routine part of visits," said Shelly F. Greenfield, director of clinical and health services research and education in the Alcohol and Drug Abuse Treatment Program at McLean Hospital and corresponding author for the study.

"In many specialized medical settings, screening for alcohol problems is even less frequent," she added. "For example, in clinics that treat TB, it would not be common practice to screen for alcohol problems, yet alcohol problems often co-occur among patients with TB."

Greenfield said she and her colleagues chose to conduct their study in Tomsk, Russia, because of its high rates of both alcohol problems and tuberculosis. "In Tomsk, we found that alcohol disorders in this population are common, with 50 percent of all TB patients meeting criteria for alcohol abuse or dependence sometime during their lifetime."

"This study is particularly important for Russia where multi-drug resistant TB is common," observed George Woody, a professor in the department of psychiatry at the University of Pennsylvania and Treatment Research Institute, "and where medical specialties are divided into silos that require patients to visit multiple providers for problems that are closely linked and could be better managed by integrated approaches like the one the authors are testing."

"Alcohol disorders not only place individuals at increased risk for acquiring a number of diseases, but once people acquire a disease like TB, alcohol places them at higher risk for poor outcome and death," added Greenfield. "This is because alcohol can suppress the immune system, alcohol hepatitis can complicate TB treatment since many TB medications are potentially toxic for the liver, and people with drinking problems are also less likely to be able to adhere to their TB treatment."

As part of the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis (IMPACT) trial, Greenfield and her colleagues divided 200 patients—confirmed to have alcohol abuse or dependence, newly diagnosed with TB, and initiating treatment in the Tomsk Oblast Tuberculosis Service—into one of four groups: 1) oral naltrexone + brief behavioral compliance enhancement therapy (BBCET) + treatment as usual (TAU); 2) brief counseling intervention (BCI) + TAU; 3) naltrexone + BBCET + BCI + TAU; and 4) TAU alone. The trial is ongoing.

"To our knowledge, this is the first study to examine the feasibility of delivering alcohol treatment as part of routine TB care," said Greenfield, "and to assess this treatment model’s impact on both TB and alcohol outcomes. If proven feasible and effective, this treatment model could be adapted for patients with AUDs and co-occurring medical conditions in other settings, specifically, anywhere co-occurring AUDs adversely affect TB outcomes, including the United States."

"The idea of integrated treatments is not new, but only just beginning to be studied and implemented in Russia and other countries, including the U.S.," said Woody.

"These findings show the universality, practicality, and potential importance of developing integrated treatments for alcoholism, HIV, and other serious health problems. They could be life-saving not only for the affected individuals, but also for the community that is at risk for the spread of TB via cases that are inadequately treated due to poor adherence to prescribed medication. Finally, these findings could easily be applied, would likely be cost-effective, and could contribute to current efforts to reduce overall medical treatment costs."

The impact that alcohol dependence can have on a person and the people that care about them can be profound. Many of these people do not want to live with this dependence every day, but have yet to find a way to escape it completely.

Now, new research may offer hope. Science Daily recently reported on a study completed by researchers at the Sahlgrenska Academy, Gothenburg. These researchers have discovered a new brain mechanism that is involved in alcohol addiction. This mechanism also involved the stomach hormone ghrelin, a hormone produced by the stomach, which signals in the brain increases in hunger.

In this study, it was discovered that when ghrelin’s actions in the brain are blocked, the effects of alcohol on the reward system are reduced. When examined with alcohol addiction, the finding highlights the reward system of the brain as a key target for ghrelin’s effects. This discovery could lead to potential new therapies for those suffering with alcohol dependence.

“Ghrelin’s actions in the brain may be of importance for all kinds of addictions, including chemical drugs such as alcohol and even food” said Suzanne Dickson, Professor of Physiology, a leading expert in appetite regulation, in Science Daily.

This work is the result of a unique collaboration between the research groups of Prof Suzanne Dickson and Prof Emeritus Jörgen Engel, including researchers Dr Elisabet Jerlhag and Dr Emil Egecioglu.

This collaboration of work demonstrated that mice treated with ghrelin increase their alcohol consumption. When ghrelin’s actions were blocked, these mice no longer showed a preference for an alcohol-associated environment. The alcohol was no longer able to produce the addictive effects, including reward searching behavior.

“If we can develop drugs that block the receptors for ghrelin, we could have a new effective treatment for alcohol dependence. It may however take several years until such a pharmacological treatment will reach the patient”, said Professor Emeritus Jörgen Engel, an authority on research on alcohol dependency at the Sahlgrenska Academy.

The impact that drug and alcohol treatments can have vary on a case by case basis and the only way to improve overall treatments is to study the overall effectiveness. This effectiveness is measured by the number of people who successfully complete treatment versus the number that drop out of treatment.

Overall, clients in outpatient treatment programs prove to have the lowest treatment completion rates of all treatment types. As a result, it is important to understand those characteristics common in clients who successfully complete treatment and identify those who are at a higher risk for failing to complete treatment.

According to The Treatment Episode Data Set (TEDS) Report for April 23, 2009, a number of factors can contribute to a person’s success in an outpatient treatment program. This particular report examined the Treatment Outcomes Among Clients Discharged from Outpatient Substance Abuse Treatment.

This research points to one certainty in successful completion rates: those who reported primary alcohol abuse had the highest completion rate among clients discharged from outpatient service settings in 2005. By comparison, completion rates were the lowest for those who reported primary opiate or cocaine abuse.

There also appeared to be a variance in the genders and educational levels. Males were more likely than females to complete outpatient treatment. In addition, as the educational level increased, so did the proportion of client discharges that had successfully completed treatment.

The way in which the client had been referred into treatment also played a role in their likelihood of successful completion. Those clients who were referred to treatment through an employer or Employee Assistance Program (EAP) or the criminal justice system were more likely to complete the outpatient treatment than those referred by other means.

In 2005, there were 1.37 million client discharges with a reported reason for discharge from either outpatient or intensive outpatient care. Among this group, 44 percent completed treatment, 25 percent dropped out of treatment and 8 percent had their treatment terminated by the facility. These findings indicate that outpatient client discharges were more likely to complete treatment than to drop out or have services terminated by the facility.

Clients reporting to treatment with an alcohol addiction tended to fare better than their opiate or cocaine addicted counterparts. Of those outpatient client discharges with alcohol as the primary abuse substance, treatment was completed by 46 percent. For those with an opiate abuse problem, completion was only 23 percent, while cocaine addicts completed treatment 25 percent of the time.

Gender and race also tended to play a strong role in a client’s ability to complete treatment. Males were more likely to complete treatment than females at 39 versus 32 percent. A similar proportion was also represented among those who dropped out of treatment.

Treatment completion appeared to be highest among Whites and Asian/Pacific Islanders who reported a 40 percent success rate. The lowest rate of 27 percent was among Blacks. The latter was also the only group in which a lower proportion completed outpatient treatment than dropped out of the treatment, represented by 27 percent versus 32 percent. Hispanic clients discharged as completed or dropped out came in at 35 and 33 percent respectively.

Those clients who were discharged with successful completion of the outpatient treatment program also increased as the level of education increased. While those with less than a high school education completed treatment 31 percent of the time; those with some college completed treatment 41 percent of the time. Employment also played a factor as those with a job tended to complete treatment more often than those without work.

While all of these factors contributed to the likelihood of whether or not a client would successfully complete outpatient treatment for substance abuse, the findings from this analysis prove that client discharges were more likely to have completed treatment than to have dropped out or been terminated by the facility. Understanding all characteristics that contribute to successful completion of a program can help to improve that program and therefore maximize the benefit to the entire client base.

Researchers have discovered a new brain mechanism involved in alcohol addiction. When the stomach hormone ghrelin is blocked in the brain, alcohol’s effects on the reward system are reduced. This important discovery could lead to new treatments for alcohol dependence and other types of addiction.

Ghrelin is a hormone produced by the stomach and increases hunger when signaled in the brain. “Ghrelin’s actions in the brain may be of importance for all kinds of addictions, including chemical drugs such as alcohol and even food,” said Suzanne Dickson, Professor of Physiology and a leading expert in appetite regulation.

Dickson and colleagues at the Sahlgrenska Academy, Gothenburg, showed that ghrelin increased alcohol consumption in mice. When ghrelin’s actions were blocked (by administering ghrelin receptor antagonists), the mice no longer showed preference for an alcohol-associated environment. In other words, alcohol was no longer able to produce its addictive effects, which include reward seeking behavior (similar to craving in alcohol dependent patients).

“If we can develop drugs that block the receptors for ghrelin, we could have a new effective treatment for alcohol dependence. It may however take several years until such a pharmacological treatment will reach the patient”, said Professor Emeritus Jörgen Engel, an authority on research on alcohol dependency at the Sahlgrenska Academy. The group has submitted a patent application for this invention.

If you wake up day after day feeling the effects of heavy drinking, yet continue to resort to the same behavior despite the consequences, you may wish you could just take a pill to crush any desire to drink again. You’re not alone. Alcoholism affects more than 17 million people. It’s a devastating disease that wrecks lives and relationships. But there is hope on the horizon. Researchers are working diligently to discover the right combination drug that will prove effective in treating alcoholism.

Topiramate May Prove Effective

One such drug that shows promise in clinical trials conducted in 2008 by the University of Virginia Health Systems team is topiramate, which decreases heavy drinking and reduces the physical and psychological harm that dependence on alcohol causes.

The drug, originally discovered in 1979, is approved by the Food and Drug Administration for treatment of epilepsy and migraines. Following clinical trials, researchers now believe topiramate will work to treat alcoholism as well. Ortho-McNeil Neurologics, Inc., is the manufacturer of the drug, and also provided funding for the study.

How It Works

According to researchers, topiramate has a two-pronged attack. First, it blocks the right amount of alcohol’s “feel-good” effects, caused by release of increased levels of dopamine following alcohol consumption. Second, topiramate interferes with the protein glutamate, which normally excites dopamine neurons. By interfering, it works to reduce alcohol’s pleasurable effect. Alcoholics taking the drug in clinical trials receive less enjoyment from alcohol, experience reduced cravings for it, and are better able to stop drinking.

A side benefit is that topiramate also lowers cholesterol levels and blood pressure, which may lead to a reduction in heart disease in alcohol-dependent individuals taking the drug. A decrease in liver enzymes as well as cholesterol levels from topiramate may also reduce fatty liver disease risk which leads to cirrhosis, end-stage liver disease and death in many alcoholics.

Seroquel XR – Sleeping Aid May Help With Alcoholism

Another drug currently being tested for its potential to treat addiction to alcohol is seroquel XR, a drug marketed as a sleeping aid. Clinical tests in England in 2008 and University of Pennsylvania in 2007 show that Seroquel XR helped some heavy drinkers to “become completely sober” and relieved many of the participants’ sleep problems.

How It Works

A common symptom of alcoholism and binge drinking is the inability to sleep – without a drink. Night after night without sufficient sleep perpetuates a vicious cycle. At first, alcohol seems to help some people sleep, but they soon wake up and have difficulty falling back asleep. Habitual drinking leads to eventual sleep disruptions throughout the night.

Seroquel XR may help block, or significantly reduce, the cravings for alcohol, say clinical researchers. It could also help alcoholics avoid resorting to more drastic measures to combat their addiction later in life.

Naltrexone and Modafinil: a One-Two Punch for Alcohol and Cocaine Addiction

According to the National Institute on Drug Abuse (NIDA), naltrexone is a medication currently being used to treat drug and alcohol addiction. It was originally developed to fight heroin addiction, but researchers found that it was effective in curbing cravings for alcohol by blocking opiate receptors in the brain.

Modafinil is a medication that may enhance mood and increase energy levels in cocaine addicts. Currently in phase II, a study combining the two medications seeks to determine effectiveness in reducing drug and alcohol abuse in individuals undergoing substance abuse treatment.

How It Works

Naltrexone blocks the “high” feeling users get from alcohol and drugs. Modafinil improves energy and enhances mood in patients suffering from narcolepsy and the preliminary indications are that it will do the same thing for cocaine addicts, thus countering the effects of cocaine withdrawal.

New Drugs on the Horizon?

With all the attention to alcoholism and its devastating effects on the individual and society, researchers continue to search for solutions that will put an end to alcohol addiction. Although certain medications may prove effective for some individuals, no single medication will work for everyone. That won’t stop researchers, however, who push on in their search for the magic pill to stop addiction.