Evidence Review: Anti-Drinking Drug Shows Modest Success

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No alcohol sign at Museumplein

Only three medications are approved by the government to treat alcoholism: Antabuse (disulfiram), Revia (naltrexone) and Campral (acamprosate). None is anything close to a cure, but a new review of the research on acamprosate suggests that it can be useful for helping alcoholics stay sober.

The review by the Cochrane Collaboration included data on 6,915 patients involved in 24 randomized controlled trials, some of which compared naltrexone with acamprosate. Both drugs were equally effective — or ineffective, depending on your point of view. They were studied in conjunction with talk therapy and other types of social support for recovery.

Compared to placebo, acamprosate increased the number of days drinkers stayed abstinent by about 11%, and reduced the odds of their return to drinking by 9% during a 3- to 12-month follow-up period. Combining naltrexone and acamprosate increased the odds of sobriety by 30% — but this drug cocktail had so many side effects that many patients simply dropped out.

In the review, recovery from alcoholism was defined as complete abstinence. But some addiction researchers question whether success must be defined this way, or whether treatments like acamprosate can’t be used toward other, more moderate goals. Many people with addictions, as well as the experts who study them, are beginning to embrace the idea that there are multiple paths to recovery, which takes many forms — and not all begin or even end with abstinence.

The review is here [pdf]; a full summary of the results can be found on MedPageToday.

If you’re interested in more on alcoholism and other addictions, watch this space. Starting this week, we’ll be starting a series on addiction and the controversy over the definition of true recovery.