Why a promising treatment for alcohol abuse is barely used

Summary

Alcohol abuse remains one of the leading causes of death in the U.S., yet effective treatments are underutilized. Medications designed to curb alcohol cravings, like a long-acting drug that blocks alcohol's pleasurable effects, are showing promise but are rarely prescribed. Personal stories of recovery, like those of a woman and a man, highlight how these medications can transform lives, helping individuals regain control over their drinking. However, systemic barriers such as lack of awareness among doctors and outdated FDA approval criteria prevent wider access to these life-changing treatments.

Takeaways

• 😀 Alcohol kills more Americans every year than opioids or other illegal drugs, highlighting its deadly impact on public health.
• 😀 Despite nearly 29 million Americans suffering from alcohol abuse disorder, less than 2% receive medication to treat it.
• 😀 Promising medications that help control alcohol consumption, like a long-acting drug, are underutilized due to a lack of awareness among healthcare providers.
• 😀 One woman shared how she struggled with alcohol addiction, and how a new medication allowed her to control her drinking and enjoy social situations without the urge to drink excessively.
• 😀 The medication works by blocking alcohol's pleasurable effects on the brain, reducing cravings, and making drinking less enjoyable.
• 😀 For individuals with severe alcohol addiction, like those drinking up to 60-70 drinks a day, reducing consumption to 5-6 drinks per day would be a significant improvement, though the FDA currently considers that a failure.
• 😀 Some doctors believe that abstinence is the only treatment for alcohol use disorder, and this view hinders the use of medications that could help manage addiction more effectively.
• 😀 Misconceptions about substance abuse treatments, including the belief that only Alcoholics Anonymous can help, prevent wider use of evidence-based medications.
• 😀 Many individuals who have benefited from medications report transformative changes, including being free from constant cravings and not thinking about alcohol constantly.
• 😀 The lack of treatment access for alcohol use disorder is a major issue, compounded by stigma and misconceptions about addiction, which are often viewed as moral weaknesses rather than medical conditions.

Q & A

What is the most common and deadly drug in America?

Alcohol is the most commonly used drug and one of the deadliest, causing more deaths each year than opioids or any other illegal drug.

Why are promising treatments for alcohol use disorder not being widely used?

Promising treatments for alcohol use disorder are underutilized because most healthcare practitioners are unaware of them, and many still believe abstinence is the only effective solution.

What struggles did the woman from Princeton, New Jersey face with alcohol?

She struggled to control her drinking, often trying to cut back but finding it difficult to maintain. Her attempts to moderate were undermined by her craving for more once she had started drinking.

What medication was being studied at the University of Pennsylvania to help curb alcohol consumption?

A long-acting version of a medication was being studied at the University of Pennsylvania to help people reduce their alcohol consumption by blocking the pleasurable effects of alcohol.

How does the medication help with alcohol cravings?

The medication blocks the receptors in the body where alcohol attaches, reducing the pleasurable sensations associated with drinking. This can help individuals manage their alcohol use.

How does the drug analogy involving a car's accelerator and brake relate to alcohol use?

The drug can be thought of as a 'brake' mechanism. It helps reduce the strong 'accelerator' effect of alcohol, making it easier for individuals to control their drinking and avoid excessive consumption.

What percentage of people with alcohol use disorder receive medication to treat it?

It is estimated that less than 2% of individuals with alcohol use disorder receive medication to help manage their condition, despite its potential benefits.

What is one of the major misconceptions that doctors have about treating alcohol use disorder?

One major misconception is that abstinence and support groups like Alcoholics Anonymous are the only treatment options, which limits the use of medications and other interventions in managing alcohol use disorder.

What is the FDA's current threshold for drug approval for alcohol use disorder treatments, and why is it problematic?

The FDA requires that a viable drug must prevent 'heavy drinking days'—more than four drinks a day for men and three for women. This standard can be problematic because it does not account for individuals who drink far more, where even a reduction to five or six drinks a day would be a significant improvement.

What emotional challenges did the man who had been an alcoholic for decades face in recovery?

In addition to overcoming his addiction, the man faced emotional challenges due to estranging relationships with loved ones over the years of alcohol abuse. He felt the loneliness of sobriety, despite being sober for four years.