There are four drugs currently FDA approved for the treatment of alcoholism, and of those four, naltrexone and acamprosate are the most commonly prescribed. A recent multi disciplinary study sponsored by the National Institute on Alcoholism and Addiction, The COMBINE study, has shown that naltrexone does influence a small but still significant betterment in relapse rates, but acamprosate was ineffective.
But researchers out of the Yale University School of Medicine say that such a gross understanding of the effectiveness of the drugs is actually misleading, and to truly use these drugs effectively, we need to have a better understanding of how well they work on distinct subgroups of alcoholics.
In controlled laboratory studies, the Yale researchers examined the comparative effectiveness of Naltrexone on two distinct subgroups of alcoholics, those with a family history of the disease, and those without a genetic background of alcoholism. The drinking levels of the two groups were compared on a number of different dosage strength of naltrexone.
It works for some…a disaster for others
The researchers were pleased to see that naltrexone did have significant betterment effect on the hereditary alcoholics, and the higher the dose given, the less these alcoholics drank. Contrarily, the drug did not work for those without a family history of alcoholism, and when given in higher does, these alcoholics even drank more!
The study leaders conclude that naltrexone may have more value than limited success rates calculated from large field trials may indicate, and with a better understanding of the effects of the drug on different sub groups of alcoholics, the drug may be prescribed in a more targeted and more effective manner.
More research is clearly needed
Hopefully, as researchers gain a broader understanding of the different manifestations of subgroups of alcoholic use, treatments in general will evolve to better match the needs of the individual alcoholics. The results of the study indicate a promising role for naltrexone, and it’s obviously very beneficial to know that when prescribed to non hereditary alcoholics, it seems to worsen the problem! The study further indicates how powerfully influential the genetic component to alcoholism is, and although still poorly understood, many of the secrets to effective treatments may well emerge as scientists better understand the genetic predisposition to alcohol abuse and alcoholism.