I encourage reading the article just published today in the NYT about the low levels of doctors prescribing current medicines that have been shown to be effective for some. It is not only a struggle to change perceptions to raise funds into research, it is also a struggle to change perceptions and get those medicines which are developed accepted by society. Articles like this help change perceptions and are a great benefit to FAR’s mission.
The comments written by readers are very interesting as well, and telling. They provide insight into many peoples preconceptions about “pills” and why maybe our society finds it hard to think in the long term, which is what research is all about.
Here is a link to the article:
Drugs to Aid Alcoholics See Little Use, Study Finds
The article mentions naltrexone – which has been FDA approved for alcoholism for many years. It helps about 20% of those who take it. Since that initial FDA approval, a genetic variant has been found to determine beforehand whether the patient is among that 20% who are helped by naltrexone. Patients can be tested before hand vs just trying it to see if it helps. It will be some time before FDA approval of the genetic variant testing. Two other medications are in the pipeline – topiramate and baclofen – with topiramate being further along. Even more promising – they do not all act in the same way medically – thus will potentially cover a wide range of people with alcoholism. Just as in many diseases, different medicines help different people with the same disease.
These drugs are not effective in my experience. On several fronts. I enthusiastically used them early in my Addiction medicine career, but unless patients were engaged in intensive group or one-on-one therapy, AND attending AA FREQUENTLY, the craving reduction effect was minimal, and compliance poor. One requires 6 pills/day! I had one patient who was drinking over 30 beers/day, who dropped his intake on naltrexone (injectable) to 20 beers/day, but because his addiction was unaddressed (Meetings, counseling, etc) he quickly became non compliant. My vote- don’t bother.
Mark Logan MD
Accumulating data from Dr Leeann Kaskutis in California are vigorously supporting a dose-response relationship between AA and quality long term abstinence in the chronic alcoholic population. Of course, the academic community doesn’t want to hear this.