Medication to Improve Outcomes in Alcohol Use Disorder
Some experts in the field of substance abuse are arguing for a change in the thinking of how to treat Alcohol Use Disorder (AUD). Most clinicians, with the focus being on sobriety, refer patients to detoxification and substance abuse programs, which is appropriate. Many clinicians do not consider treatment options to reduce alcohol use as a treatment goal. It has been shown that even avoidance of heavy drinking can reduce some of the major negative effects of alcohol use, including medical and occupational effects.
Naltrexone is a medication that blocks opioid receptors. It works by removing the positive reinforcement of drinking on the brain. Studies have shown that it can help prevent the development of severe alcohol use disorder. It does not necessarily help on its own to achieve abstinence from alcohol, but even reduction of heavy drinking can have improvements in outcomes. Studies have shown that it is effective in reducing and preventing relapses into heavy drinking. It can be particularly helpful in people who have high cravings for alcohol. There is a common belief that if someone has a propensity towards addiction, that they should avoid any exposure to a substance. A medication like this could change that way of thinking, that even eliminating heavy drinking and limiting the euphoric effects of alcohol to reduce the amount of alcohol consumed can make a real difference in measurable health and lifestyle outcomes.
Please see the e-Weekly newsletter dated August 25, 2016 for more details on dosing naltrexone and the side effects to monitor for. The newsletter also discusses other medications that can be useful for treating alcohol abuse.
Traditionally different aspects of substance abuse treatment and related mental health concerns have remained separate – separate detoxification centers, separate mental health therapy and psychiatry, separate substance abuse therapy programs. In an effort to integrate substance abuse treatment, more and more, alcohol treatment programs are starting to offer medication augmentation to therapy. This integrative approach will hopefully lead to better success, both in terms of achieving and maintaining sobriety, for patients.