Drug appears to reduce alcoholics' craving for a drink
Sinai Samaritan is among sites testing it
By K. L. Griffin - Journal Sentinel 1/8/00

Doctors may have a safer and more effective treatment for alcoholics within a year or two, thanks to an experimental drug, tested at a Milwaukee hospital, that appears to eliminate excessive craving for a drink.

In a nationwide, double-blind study involving 600 alcoholics, acamprosate was found to block withdrawal symptoms of alcoholism - tremors, anxiety and irritability - resulting in a drastic reduction in the need to drink, increased abstinence and a sharply reduced relapse rate.

"For a long time, the study of alcoholism hasn't been considered sexy because alcoholism has always been stigmatized as a problem of willpower," said Lance Longo, medical director of addiction psychiatry at Sinai Samaritan Medical Center, one of the 25 test sites used for the study. "But we are learning that it really is a brain disease, that after a while, begins to take a life of its own."

Acamprosate, a psychotropic drug, appears to work by reducing nerve transmission activity in the brain.

Although detailed findings from the study cannot be disclosed until after an FDA review in February, Longo did say that the drug worked best in those people who were "motivated and had abstinence as a goal." After the review, the FDA will determine whether the drug can be used for treatment.

According to the National Council on Alcoholism and Drug Dependence, approximately 14 million people, or one in every 13, meet diagnostic criteria for alcohol abuse. Studies indicate that 50% or more of people treated for alcoholism will relapse within three months and 75% within one year. The rate increases to 90% after four years.

Currently, naltrexone, which was approved by the FDA in 1994, is in use. It blocks painkilling and pleasure-producing receptors in the brain, dampening the euphoria - the "buzz" - produced by alcohol. That was the first drug since Antabuse in 1951 to be approved to treat alcoholism.

But naltrexone can be toxic to the liver, which is of special concern in drinkers who may already have liver damage. For that reason, the drug has not been widely used, Longo said.

In contrast, acamprosate has no effect on the liver, and side effects were limited to diarrhea, he said.

"Medications aren't the magic pills for curing alcoholism," Longo said. "But for some people, where the usual talk therapies used as prevention aren't enough, medications may be an additional piece of the pie for recovery."

Longo is seeking volunteers for additional studies to look at the effectiveness of combination drug therapy and behavioral management as treatment alternatives. Participants must be 18 or older, dependent on alcohol and without any other major medical or psychiatric problems.

"The more people come out of the closet and share not only their distress and success, the more people will become aware of the seriousness of the problem and look for more effective means of treatment," he said.

For more information on the study, or to volunteer, call the Center for Addiction and Behavioral Health Research at (414) 219-3509. Appeared in the Milwaukee Journal Sentinel on Jan. 8, 2000.