Drug helps stop alcohol cravings, research shows

Posted: Tuesday, May 13, 2008

A study conducted in Juneau and other parts of Southeast Alaska found that participants taking the drug naltrexone were three times more successful in maintaining abstinence from drinking than those who weren't taking the medication.

The findings were released Monday by Yale University and the Southeast Alaska Regional Health Consortium.

Dr. Robert Robin, a research scientist and psychologist who presented the findings at the Ethel Lund Medical Center in Juneau, called naltrexone "robustly effective" in stopping cravings for alcohol. Robin served as the co-principal investigator for Yale during the study.

More than one-third, or 35.3 percent, of participants taking the drug remained abstinent during the 16-week duration of the trial, compared to just under 12 percent of those who were given a placebo.

The impetus for the study originated with SEARHC, which recognized a problem with alcohol in Alaska and wanted to research treatment, said Robin, a former Juneau and Sitka resident. The study was the first of its kind in a rural area.

Naltrexone, marketed under the trade name Vivitrol, was approved by the Food and Drug Administration in 1996 to treat alcohol and some drug addictions.

The study involved 101 people from Juneau, Sitka and villages around the region who were in one of three groups that took naltrexone alone, naltrexone with the anti-depressant Zoloft, or a placebo.

Participants received 16 weeks of treatment between 2002 and 2006 that included counseling as well as follow-ups through one year.

People who took the drug reported fewer drinking-related consequences such as missing work or fighting with a spouse compared to the placebo group.

"Naltrexone was effective significantly in terms of total abstinence, time to a first drink and time to a heavy drinking episode," Robin said. "The numbers are good according to most standards."

The study group that took naltrexone with the anti-depressant did not show better results than those taking naltrexone alone.

About two-thirds of the participants were Native Alaskans. Benefits were similar among Natives and non-Natives.

"We've been talking about the super-pill or the magic pill for 50 years," said Maria Marra, a health systems specialist with SEARHC. "Whether this is it or not doesn't matter; it helps."

Robin noted that the study's high abstinence results could have been positively affected by what he called a "sobriety movement" in some Southeast communities, where social drinking or "just having a few" is frowned upon.

"As a result of this study, most of us now think of naltrexone as a potential adjunct to treatment," said Dr. Verner Stillner, director of psychiatric services for Bartlett Regional Hospital. He recalled a patient who claimed the medication had "taken away the noise" of the craving for alcohol and had been alcohol-free for a year and a half.

In the decade since the study began, a skeptical attitude toward using medication to treat alcohol dependence has changed, Stillner said. He called the work "unique" and a "monumental study in Alaska."

The results of the 10-year study will be published in the July issue of the medical journal Alcoholism: Clinical and Experimental Research.

• Contact reporter Kim Marquis at 523-2279 or e-mail kim.marquis@juneauempire.com

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