Can opiate replacement drugs be used to treat alcoholism, and just as importantly, should they? The New York Times published an article recently which weighed in on these issues, “Drugs to Aid Alcoholics See Little Use, Study Finds.” The report focused on two drugs, naltrexone and acamprosate, which have been touted as being a possibly effective treatment for alcoholism and which have been approved for use for more than a decade. It is the dream of many in the field of addiction treatment to find a pill that can be used to do away with addiction, something that has absorbed countless sums and endless hours of research.
These two drugs are supposed to work by minimizing the cravings that the person feels for alcohol through changes to the way that the brain releases certain chemicals as a reward for different stimuli. The story in the Times discussed a recent study which found that naltrexone and acamprosate have been underutilized since their release, a fact that is being attributed to uncertainty over whether or not they are effective as well as a general lack of awareness among the doctors who would be expected to prescribe these drugs.
It may be the case that the drugs intended for use in treatment of alcoholism have been underutilized, but this may not be a mistake or an oversight as the recent study would suggest. On the contrary, it may be that these drugs are being avoided by doctors who know about the side effects associated with drugs, and by those who choose not to try to treat drug addiction with more drugs. For example, the National Institute on Alcohol Abuse and Alcoholism lists common side effects of naltrexone as including:
- Nausea
- Headache
- Depression
- Dizziness
- Fatigue
- Insomnia
- Anxiety
- Sleepiness
Acamprosate is known to have similar side effects, as well as others including an extreme feeling of sadness or emptiness, fear and severe depression. Simply put, naltrexone and acamprosate interfere with the normal chemical balance in the brain, and any time that this is done one is opening the door to risky outcomes. Fortunately, there are other ways to effectively treat alcoholism and they don’t require the use of other drugs.
Long Term Treatment More Effective than Another Drug
The fact is that treating alcoholism with a pill is simply not possible, because alcoholism is more than a matter of physiological dependence. A person who gets hooked on drinking normally does so after turning to alcohol as a way to cope with the stresses and challenges in life after life has become overwhelming. Even if you can get rid of the physiological dependence on alcohol, the person is still left with these overwhelming factors in life, and is not likely to do well or stay sober without some type of address to these issues. This is why long-term, non-drug based treatment is so effective; it not only helps the alcoholic to dry out, but also helps the person to achieve true rehabilitation and a newfound level of strength and stability in life from which he or she is not likely to fall away from sobriety.
Even these supposed wonder drugs to not claim to actually cure alcoholism; instead they are just another crutch for the person to lean on. The listed uses of naltrexone, for example, include reducing a patient’s urge or desire to drink, helping patients to remain abstinent, and interfering with the patient’s desire to continue drinking after a relapse; each of these assumes that the person will need the drug to keep away from drinking and that the person will still want to drink. When it is possible to recover from alcoholism without using drugs, why would someone want to set himself or herself up for a lifetime of continued chemical dependence?
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