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Treating Alcoholism With a Monthly Shot

Study: Counseling Plus Monthly Shot of Naltrexone Shows Promise
WebMD Health News

April 5, 2005 -- A monthly shot of the prescription drug naltrexone -- plus counseling -- could help reduce heavy drinking in people with alcoholism.

That's according to a new study in the April 6 issue of The Journal of the American Medical Association. The study was funded by Alkermes Inc., which makes naltrexone.

Naltrexone is already used to treat alcoholism. The monthly shot might be a more convenient approach than current daily oral doses, say the researchers, some of whom are Alkermes employees.

"Alcoholism is a serious disease that destroys lives. As we learn more about how the brain is affected by alcohol, we are discovering how best to provide treatment -- like adding a safe medication to counseling. A long-acting injectable, which eliminates the burden of daily pill taking, will open new doors for our patients and give hope to them and their families," says researcher Helen Pettinati, PhD, in a news release. Pettinati is a research professor in the University of Pennsylvania's department of psychiatry and the director or the treatment research division in the Center for the Study of Addictions.

The news comes right before National Alcohol Screening Day. On April 7, more than 5,000 sites nationwide will offer free, anonymous screenings regarding alcohol use.

National Alcohol Screening Day is sponsored by several government agencies, including the National Institute on Alcohol Abuse and Alcoholism, a branch of the National Institutes of Health.

Alcoholism: A Chronic Disease

Alcoholism is the fourth leading cause of disability worldwide. In the U.S., it may contribute to more than 100,000 preventable deaths annually and is present in 4% of the adult population, the researchers, including James Garbutt, MD, of the University of North Carolina at Chapel Hill.

Alcoholism is increasingly viewed as a chronic disease that can be affected by genetics, social, and environmental factors, they note.

Treatment options include addiction counseling, behavioral approaches, self-help groups such as Alcoholics Anonymous, and medications.

"As with other chronic diseases, long-term comprehensive management strategies are necessary to achieve and sustain the benefits of alcohol dependence treatment," the researchers write.

Naltrexone was approved by the FDA in 1994 for treating alcohol dependence. The drug had been shown to reduce drinking frequency and the likelihood that people would relapse back into heavy drinking, say the researchers.

But naltrexone hasn't gotten widespread clinical use. That may be partly due to variations in treatment response -- which could be related to the drug's regimen, say Garbutt and colleagues.

Currently, patients take naltrexone orally every day. Sticking to a daily oral medication routine is a general problem in medicine (not just with alcoholism), write the researchers. They tried a different approach: long-acting monthly shots of naltrexone.

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