Naltrexone, a Promising New Treatment for Alcoholism and Binge Drinking

By: Alexander Graham

Alcoholism and binge-drinking are widespread problems in North America. According to a recent government health survey, almost half of American drinkers reported binge-drinking in the previous month. While some people may view binge-drinking as harmless, it is considered a major risk factor for alcohol-related illnesses and injuries. Additionally, it heightens the possibility that an individual will develop an alcohol disorder, such as alcoholism or alcohol addiction. Alcohol-related deaths in the United States have surpassed 140,000 per year, making it a major public health concern.

However, a recent study provides hope for those who struggle with binge-drinking and alcoholism. The study adds to the evidence that people who binge-drink may benefit from taking a dose of the medication naltrexone before consuming alcohol. The medication blocks endorphins and reduces the euphoria of intoxication. Naltrexone was approved in the United States for the treatment of alcohol dependence nearly 30 years ago. But it is typically prescribed for patients with more severe alcohol disorders to take daily to abstain from drinking.

A new study on alcoholism and treatment offers hope

The new study’s targeted approach is less common, although studies going back decades have demonstrated the effectiveness of the as-needed dosing method. In the study, 120 men who wanted to reduce binge-drinking but were not severely dependent on alcohol were given naltrexone to take whenever they felt a craving for alcohol or anticipated a period of heavy drinking. Each week, participants also received counseling on how to reduce their alcohol use. By the end of the 12-week study, those given naltrexone reported binge-drinking less frequently and consuming less alcohol than those who had been given a placebo, a change that lasted for up to six months.

Taking naltrexone on an as-needed basis rather than as a daily dose may be more tolerable for some people because it allows their dopamine levels to recover in between uses. The approach could also let people feel more in control of their treatment. The practice is more widely embraced in Europe, where regulators in 2013 approved the medication nalmefene for similarly targeted dosing by people trying to drink less alcohol.

Dr. Lorenzo Leggio, a physician-scientist at the National Institutes of Health, said the latest study was “very important” because, while alcohol treatments had traditionally been designed for people with severe addictions, far more people, like the study’s participants, had mild or moderate alcohol disorders. Last year, N.I.H. officials proposed rebranding these stages as “preaddiction” to underscore the need for early intervention, much as the diabetes field improved care by identifying and treating prediabetes.

Not a magic pill

While there is no one-size-fits-all approach to treating alcohol disorders, naltrexone and other approved medications are vastly underused. In a 2019 government health survey on alcohol and drug use, fewer than one in 10 people with an alcohol use disorder reported having received any treatment, and less than 2 percent of those individuals said they had been offered medication. Many physicians do not even know about the drugs.

It is important to increase awareness that there are effective medicines that can help people with their alcohol use. Patients could discuss the treatment option with their clinicians, even if it is not suitable for all. Researchers agree that naltrexone and other approved medications are vastly underused. Moreover, there is a real gap in the medical community, and many physicians do not even know about these drugs.