How can Medication Help you Curb Cravings for Alcohol? [Testimonial]
Endorphin-blocking medications have been around since 1990s when the Food and Drug Administration approved its commercialization (Carmen, Angeles, Ana, & María, 2004). Although this type of medication has proved to be really effective in helping people curb their drinking, not many people are familiar with it. One core reason is due to the fact that general practitioners don’t feel confident in prescribing it or had much training with it (Mark, Kranzler, & Song, 2003). In addition, most programs and treatments for heavy drinking are based on abstinence, which doesn’t leave space for this type of medication as they work best when taken before drinking alcohol (Heinälä et al., 2001; Rubio et al., 2002). But this has been changing and we see a shift in the way addiction is treated, with the rise of harm-reduction-based treatments and programs (Marlatt & Witkiewitz, 2002).
When abstinence isn’t an option – for various reasons such as work, social environment, personal preferences and lifestyle – harm-reduction is an effective way to tackle heavy drinking (Witkiewitz & Marlatt, 2006). By gradually reducing the alcohol consumption, rather than going ‘cold-turkey’, withdrawal symptoms are less likely to occur. It also gives the brain time to adjust to a new behaviour: drinking 1 to 2 glasses of wine on one occasion instead of a bottle of spirits.
Going into the details, endorphin-blocking medications block the dopamine receptors, so the euphoric sensation that comes from drinking alcohol is neutralised. To learn more about how this particular type of medication works, and its impact on the lives of those struggling with heavy drinking, check out the interview CBC Ontario gave on the topic – it’s eye-opening.
We recommend taking the time to hear the whole thing, but if you don’t get a chance, we’ve curated below some of the testimonials from professional and participating guests that have had experience with prescribing or taking endorphin-blocking medications to treat heavy drinking.
“[This type of medications] really help people reduce the amount they drink and sometimes stop altogether, as well as all the harms that are associated with alcohol. This is an area of great opportunity for the medical system to help support folks who are struggling with these Alcohol Use Disorders, from the mild to moderate and severe spectrums. “ Dr. Chetan Mehta, Toronto
“The evidence shows that for people who are on this medication on a daily basis, about 1 in 9 people at the end of 12 months will have completely stopped drinking. And for the people who are still drinking, there is a sizeable reduction.” Dr. Chetan Mehta, Toronto
“Naltrexone has really changed [my partner’s] life. He used to drink enormous quantities of alcohol, a bottle at a time, of vodka or other spirits. (…) It came to the point where he almost died one time from alcohol poisoning. And having Naltrexone has given him that edge. It’s incredible. At Christmas, there was no alcohol. Nobody was worried about alcohol. He wasn’t worried about alcohol. It was a really good Christmas.” Grace, Ontario
“Taking the pill on its own will do quite a bit of work but sometimes that’s not enough. [The medication] can definitely be an important part of therapy. It can really help people engage in other parts of the non-medical therapy, once they have a little bit of their edge curbed from alcohol use.” Dr. Chetan Mehta, Toronto
“Since 2016 I’ve been on Naltrexone for Alcohol Use Disorder. It’s been just a miracle for me. I was a chronic abuser of alcohol for about 10 years. I have watched Claudia Christian’s TED Talk and read the book “The cure for alcoholism”. I have taken that to my family doctor, and she refused to prescribe [the medication] (…)I had to go to a methadone clinic to get my hands on it. At this time at work, I was missing a lot, I was destroying my relationship with my life partner, and it got pretty ugly.” Alison, Stratford
“I didn’t ever think that [abstinence] would be a realistic expectation for me. Substance Use Disorders are in both sides of my familial tree and I’m still quite young so the idea of abstaining from something so socially available, accepted and even celebrated, normalized for almost 70 years, was unimaginable. The idea of being able to, if I wanted was very intriguing.” Alison, Stratford
Sometimes, hearing it from other people might be the little nudge we needed to take action. Other times, the information just sits there until we’re ready to make a change. Whatever the case might be, the evidence is there, and we hope that this interview will invite others to join us in reducing barriers to getting treatment. Heavy drinking is one of the leading risk factors for death and disability, and science-based solutions can help those who are at risk, wherever they find themselves on the spectrum. To listen to the whole interview, click here.
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References: [1] Heinälä, P., Alho, H., Kiianmaa, K., Lönnqvist, J., Kuoppasalmi, K., & Sinclair, J. D. (2001). Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a factorial double-blind, placebo-controlled trial. Journal of clinical psychopharmacology, 21(3), 287-292. | [2] Mark, T. L., Kranzler, H. R., & Song, X. (2003). Understanding US addiction physicians’ low rate of naltrexone prescription. Drug and Alcohol Dependence, 71(3), 219-228. | [3] Marlatt, G. A., & Witkiewitz, K. (2002). Harm reduction approaches to alcohol use: Health promotion, prevention, and treatment. Addictive behaviors, 27(6), 867-886. | [4] Rubio, G., Manzanares, J., Lopez-Muñoz, F., Alamo, C., Ponce, G., Jimenez-Arriero, M. A., & Palomo, T. (2002). Naltrexone improves outcome of a controlled drinking program. Journal of substance abuse treatment, 23(4), 361-366.
Alex Lee is a doctoral candidate in social work (DSW C), a licensed clinical social worker (LCSW) and Clinic Director at Alavida Health. He has over ten years of experience in designing, facilitating, and evaluating evidence-based interventions for individuals and families. Alex is trained in addressing mental health issues, trauma, and substance use and has overseen large-scale mental health services for Navy Medicine and the Red Cross. He also served as the interim Clinical Director for the Department of Mental Health and Statewide Clinical Director for Developmental Centers in California and Nevada.