No magic pill to cure alcohol dependence yet

A new study published by the scientific journal Addiction has found no reliable evidence for using nalmefene, naltrexone, acamprosate, baclofen or topiramate to control drinking in patients with alcohol dependence or alcohol use disorder. At best, some treatments showed low to medium efficacy in reducing drinking, but those findings were from studies with a high risk of bias. None demonstrated any benefit on health outcomes.

The study pooled the results from 32 double-blind randomised controlled trials representing 6,036 patients, published between 1994 and 2015. The studies compared the effects of oral nalmefene (n=9), naltrexone (n=14), acamprosate (n=1), baclofen (n=4) and topimarate (n=4) against placebo.

Many of the studies provided unreliable results due to risk of bias (potential exaggeration of the effects of the drug). Twenty-six studies (81%) showed an unclear or high risk of incomplete outcome data due to the large number of withdrawals. Seventeen studies (53%) showed an unclear or a high risk of selective outcome reporting, as they did not include a protocol registration number, which would allow another researcher to check whether all outcomes were reported.

Few Young People Treated for Opioid Addiction Get Medication-Assisted Treatment

Only 27 percent of youths treated for opioid addiction receive buprenorphine or naltrexone, known as medication-assisted treatment, a new study finds.

“These medications are considered the evidence-based standard of care for opioid addiction by the American Academy of Pediatrics,” said lead researcher Dr. Scott Hadland of Boston University School of Medicine.

Buprenorphine (sold as Suboxone) has been shown to reduce cravings, while naltrexone (sold as Revia and Vivitrol) blocks the high from opioids, HealthDay reports.

Full story of opioid addiction and medicated-assisted treatment at drugfree.org

Medications underutilized when treating young people with opioid use disorder

Only one in four young adults and teens with opioid use disorder (OUD) are receiving potentially life-saving medications for addiction treatment, according to a new Boston Medical Center (BMC) study published online in JAMA Pediatrics.

Buprenorphine and naltrexone are medications used to treat OUD that help prevent relapse and overdose when used appropriately. In late 2016, the American Academy of Pediatrics recommended, for the first time, that providers offer medication treatment to adolescents with OUD.

Prior studies have shown that among all adults in treatment for opioids, one-third started using opioids before age 18, and two-thirds started before age 25. Unlike methadone, buprenorphine and naltrexone can be offered in the primary care setting. However, few teens receive medication due, in part, to a widespread shortage of physicians who have received a waiver certification required to prescribe buprenorphine. And, as researchers note, of all of the physicians who are certified in the United States, only one-percent are pediatricians.

Full story of treating young people with opioid use disorder at drugfree.org

Naltrexone: Injectable or oral?

Medications can help people who drink excessive amounts of alcohol. One medication that can reduce alcohol craving and help promote recovery is naltrexone, which is approved for treatment of alcohol dependence by the Food and Drug Administration. It is available in two forms — injectable and oral. This pilot study evaluated the feasibility of injectable versus oral naltrexone, administered in a hospital setting to enhance treatment compliance when patients leave the hospital.

Fifty-four veterans diagnosed with alcohol use disorder were recruited from a larger population of 113 veterans hospitalized for an acute medical or psychiatric illness. Participants were randomly divided into two groups: one received either 50-mg oral naltrexone for daily use plus a 30-day prescription; the other received a 380-mg intramuscular 30-day sustained release naltrexone injection prior to discharge, with a second injection one month later. Researchers followed up with both groups at 14 and 45 days following discharge.

Full story of injectable versus oral naltrexone at Science Daily

Public Health Officials Urge Doctors to Consider Medications to Treat Alcohol Addiction

Public health officials are urging doctors to consider prescribing medications to treat alcohol addiction, NPR reports. The drugs can be used alongside or in place of peer-support programs.

“We want people to understand we think AA is wonderful, but there are other options,” said George Koob, Director of the National Institute of Alcohol Abuse and Alcoholism. He says there are two drugs on the market for patients with alcohol cravings, naltrexone and acamprosate. “They’re very safe medications, and they’ve shown efficacy,” he said.

Full story of doctors to treat alcohol addiction at drugfree.org