With over 76 million people worldwide suffering from some kind of alcohol-related condition is there anything that the medical profession can do? Is there a magic pill to help those who find that when it comes to drinking - one drink is too many; a thousand never enough.
The World Health Organisation estimates that around 76 million people globally currently suffer from some kind of alcohol-related condition. Alcohol remains the world's number one killer causing almost 2.5 million deaths a year or just about 4% of the world's total. On average each human being consumes 6.1 liters of alcohol a year however when extrapolated to focus on the citizens of Europe and North America this figure becomes much higher.*
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With such sobering statistics it is no surprise that there are numerous pharmacologic medications available to assist those afflicted with an alcohol-related condition.
Currently there are three main medicines approved for the treatment of alcohol misuse - Acamprosate, Naltrexone and Disulfiram. More recently a fourth, Baclofen, has increasingly been prescribed off-label as a potential cure.
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Baclofen is an muscle relaxant developed for patients suffering from multiple scleroses. In 2002 US/French pediatrician Dr Olivier Ameisen, an alcoholic himself, began experimenting with Baclofen. He found that while taking a high dose of this medication his cravings and dependency on alcohol reduced to almost zero. Many private treatment centers are now offering courses of Baclofen to their patients as increasingly studies are finding that this medication is a cost effective solution to alcohol dependency with very few side effects.
Disulfiram or Antabuse is probably the best known medication for alcohol misuse. Created by accident in 1948, Antabuse works by preventing the liver from turning acetaldehyde into acetic acid. acetaldehyde is toxic to humans, it is the cause of hang overs and a build up of acetaldehyde causes side effects such as nausea, shortness of breath and dizziness. More sever reactions can also take place including heart attacks, comas and even death. Reactions to acetaldehyde can occur from having as little as 5-10mg alcohol per 100ml blood. This is far less than even a single unit of alcohol. As Antabuse makes patients so sensitive to the effects of alcohol those taking it need to be aware of the hidden alcohol in food and cosmetics. Products such as ketchup and mayonnaise often contain spirit vinegar which is actually mildly alcoholic. It is not uncommon for those particularly affected by Antabuse to stop eating these products while they remain on the medication.
Personal experiences of taking some of these medications can be found on this alcoholic blog.
Acamprosate or Campral is the most recent drug approved to be prescribed for the treatment of alcoholism. While it is not known how Acamprosate works, doctors have found that it helps reduce the cravings and distress experienced in alcohol dependent individuals after they have stopped drinking. Acamprosate has become popular with the medical profession as it has few effects and is a relatively cheap medication. The downside of Acamprosate is that if a patient begins drinking again while taking it the positive effects Acamprosate provides are quickly nullified and a return to serious alcoholism may be inevitable.
The final drug commonly prescribed is Naltrexone, sometimes known as Revia or Depade. Unlike with Disulfiram and Acamprosate patients taking it can, and in some instances are encouraged to, continue drinking alcohol. Naltrexone works by preventing the brain from releasing pleasure endorphins that generally accompany the consumption of alcohol. A patient taking Naltrexone will still feel the effect of consuming alcohol but will not feel any pleasure from doing so as brain-stimulation is reduced. Side effects such as a hang over will still occur but as patients no longer feel the 'high' from drinking tend to reduce or stop drinking all together.
*Global Status Report on Alcohol and Health 2011