Craving Reduction Medications
What medications are used in the direct treatment of alcoholism?
Anti-craving drugs and Brief-TSF, a good combination.
The process of Brief-TSF supports the use of anti-craving medications to aid in alcoholic relapse prevention. Most prescribing authorities require that alcohol craving medications be accompanied with counseling. Evidence based best practice guidelines recommend the use of craving reduction drugs where appropriate
Alcoholics Anonymous has a clear policy on the use of medications to help restore health. As always AA makes suggestions to its members;
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During their drinking days, many alcoholics made their problems worse by mixing liquor with sedatives, tranquilizers, marijuana, or other drugs. They may cling to the pill or drug habit even after they stop drinking. It will probably also be wise if you encourage the alcoholic to seek medical advice from a physician knowledgeable about the special problems recovering alcoholics experience. Using medications or discontinuing their use without proper professional guidance may be dangerous, and either course may lead a sober alcoholic back to the first drink.
(The pamphlet "The A.A. Member – Medications and Other Drugs" discusses the problem in detail.) (AA, 1976).
’Alcoholics Anonymous and the Use of Medications to Prevent Relapse’.
This study did not find any strong or widespread negative attitudes toward medication for preventing relapse among AA members. Most of those who experienced unfavorable pressure continued taking their health medication (Rychtarik et al, 2000).
Two Craving Reduction Medications
There are two alcohol anti-craving drugs recommended for alcoholism or alcohol dependence. These are; acamprosate tablets (Campralâ„¢) and naltrexone tablets (Reviaâ„¢).
A new formulation – long-acting Injectable naltrexone – is currently under development. May 2007 – Now available in the USA.
Naltrexone Tablets (ReViaâ„¢)
A Cochrane Review of 29 studies from around the world concluded that naltrexone provides real help to people trying to moderate their drinking and "should be accepted as a treatment for alcoholism.â€
This study reported that in comparison to placebo, a short-term treatment of naltrexone (ReViaâ„¢) significantly decreased relapse by as much as 36% over and above normal rates, and significantly reduced withdrawal symptoms.
Naltrexone and intensive psychosocial treatment, such as counseling or attending AA meetings, was superior in the medium-term. (Srisurapanont et al, 2005).
Acamprosate (Campralâ„¢) Tablets
Seventeen randomized, placebo-controlled trials of acamprosate (Campralâ„¢) were reviewed covering 4087 alcoholics. Continuous abstinence rates at 6 months were significantly (54%) higher in the acamprosate-treated patients compared to placebo patients. Acamprosate also had a modest but significant beneficial effect on retention in treatment (Mann et al, 2004).
Overall, patients treated with acamprosate (Campralâ„¢) exhibited a significantly greater rate of treatment completion, time to first drink, abstinence rate, and/or cumulative abstinence duration than patients treated with placebo. The drug’s reliable effect on prolonging abstinence, in conjunction with an excellent safety profile, suggests that acamprosate may be useful for a broad range of patients with alcohol dependence (Mason, 2001).
Drinking and craving alcohol must be addressed first
