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Medications to treat alcohol abuse are often overlooked

Drugs that could help millions of people who struggle with alcohol abuse problems are often overlooked by doctors and patients, according to public health officials.

The medications naltrexone and acamprosate are the two prescriptions on the market which can reduce cravings in patients grappling with binge drinking and heavy drinking issues.

“They’re very safe medications,” George Koob, the director of the National Institute of Alcohol Abuse and Alcoholism (NIAAA), told Kaiser Health News. “And they’ve shown efficacy.”

A 2014 report in the Journal of the American Medical Association that looked at past studies found that both drugs “were associated with reduction in return to drinking.”

Report: Excessive drinking responsible for 1 in 10 adult deaths

The NIAAA has developed a branch dedicated to developing drugs and is supporting clinical trials. NIAAA and the Substance Abuse and Mental Health Services Administration also asked a panel of outside experts to report last summer on drug options, according to the Kaiser Health News report.

“Current evidence shows that medications are underused in the treatment of alcohol use disorder, including alcohol abuse and dependence,” the panel reported.

Peer-support and 12-step programs such as Alcoholics Anonymous can be helpful, but more can be done to assist the approximately 18 million Americans who live with alcohol use disorders, according to experts at NIAAA. Only about 1.5 million adults received treatment at a specialized facility in 2014, government health officials said. And according to Kaiser, one government-funded study out last year showed that only 20 percent would ever receive any treatment.

“We want people to understand we think AA is wonderful, but there are other options,” said Koob. “Let a thousand flowers bloom, anything helps.”

Difference between binge drinking and alcoholism

Naltrexone is available as an oral and injectable medication and was approved for use in alcohol addiction in 1994. It is also used to treat opioid addiction. Acamprosate was approved in 2004 and comes in tablet form. (These drugs work differently than Antabuse, which makes people sick if they consume alcohol and has not proven effective in clinical trials.)

Dr. Larissa Mooney, associate clinical professor in the UCLA Department of Psychiatry and Biobehavioral Sciences and director of the UCLA Addiction Medicine Clinic, agreed with the panel’s findings. “Medications for alcohol use disorder are often underutilized,” she told CBS News.

“Given that addiction is typically a long-term condition marked by relapse, individuals may need to try more than one approach to treatment, or a combination of treatments to facilitate successful recovery. Medication treatment in combination with behavioral interventions can be very effective,” Mooney said. 

She said the drugs are “treatment tools” that may help to reduce cravings or relapse risk in people struggling with alcohol abuse. 

“Given the serious potential health and psychological consequences of excess drinking, any intervention that can help to reduce harms is worth consideration,” she said.