Naltrexone and other Withdrawal Meds
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Join Date: May 2004
Location: Southern Cal
Posts: 408
Naltrexone and other Withdrawal Meds
FYI
A friend sent this to me and I wanted to pass it along.
Agree,Disagree?
Here is is
"Hey Bob: I've probably mentioned this to you before, but I'm sending
you a recent article that that might interest you or your doctor.
May 6, 2004 (New York) - Some newly approved agents and new
formulations of existing agents can aid patients recovering from addiction by
reducing sensations of craving, according to findings presented here at the
157th annual meeting of the American Psychiatric Association.
"Alcoholism is a disease of the brain that doesn't go away with
abstinence," presenter Charles O'Brien, MD, PhD, told Medscape in a phone
interview. "At least 50% of alcoholics could be helped with craving
sensations by naltrexone, and it's a tragedy that more physicians don't use
it." Dr. O'Brien is the Kenneth Appel professor of psychiatry at the
University of Pennsylvania in Philadelphia, where he is also the director
of mental health research at Veterans Affairs.
Naltrexone has been used for some time to treat heroin addiction, but
the newly available sustained-release formulation is more accessible and
is also effective in treating alcoholism, he said. "This formulation is
easy to use, nontoxic, and not damaging to the liver," Dr. O'Brien
said. "HMOs are starting to cover treatment with depot naltrexone because
they realize it's cost-effective.
For alcohol-dependent patients, alcohol consumption interacts with the
dopamine system in a manner similar to that of opioids, Dr. O'Brien
said. Naltrexone blocks opiate receptors and therefore reduces alcohol
cravings. However, of the 20 million alcoholics in the U.S., only 5% are
treated with naltrexone.
This low rate of treatment reflects American attitudes that alcoholism
"is a disease of willpower," Dr. O'Brien said, noting that in Europe
and Australia, naltrexone is routinely given to alcoholics. He added that
naltrexone should be given in conjunction with supportive therapy, such
as counseling, cognitive behavioral therapy, or therapy from self-help
groups such as Alcoholics Anonymous.
Cravings typically subside within a few days of treatment, with
sufficient recovery six months after treatment that some physicians withdraw
treatment at that point. However, when naltrexone is discontinued,
cravings typically return three months later, Dr. O'Brien said, comparing
maintenance therapy with naltrexone to antihypertensive therapy.
Other medications that block craving include bupropion, used in smoking
cessation; the experimental agent rimonabant, used to treat both
excessive eating and smoking cessation; and acamprosate, which is also being
used to treat the cravings of alcoholism.
Two experts expressed confidence that these agents will address a need
in addiction therapy.
"Eventually we will have agents that help to maintain people off drugs
and alcohol after they have quit," Eric Collins, MD, told Medscape,
adding that the trend is to seek specific agents to address specific
addiction issues. These agents represent "a promising new strategy." He is
an assistant professor of psychiatry at Columbia University in New York
City.
"There will be certain subgroups for which one drug or another will
work," David Baron, DO, told Medscape. He is the chair of psychiatry at
Temple University in Philadelphia, Pennsylvania. Dr. Baron agreed that
tailoring the therapy to the patient is the most likely way in which
physicians will use these agents. Therapies to effectively address specific
craving "are right on the edge of becoming a standard treatment of
choice," he said. "We're not that far away from identifying which patients
will respond."
APA 157th Annual Meeting: Abstract NR451. Presented May 4, 2004.
Additional reporting by Charlene Laino.
Reviewed by Gary D. Vogin, MD
A friend sent this to me and I wanted to pass it along.
Agree,Disagree?
Here is is
"Hey Bob: I've probably mentioned this to you before, but I'm sending
you a recent article that that might interest you or your doctor.
May 6, 2004 (New York) - Some newly approved agents and new
formulations of existing agents can aid patients recovering from addiction by
reducing sensations of craving, according to findings presented here at the
157th annual meeting of the American Psychiatric Association.
"Alcoholism is a disease of the brain that doesn't go away with
abstinence," presenter Charles O'Brien, MD, PhD, told Medscape in a phone
interview. "At least 50% of alcoholics could be helped with craving
sensations by naltrexone, and it's a tragedy that more physicians don't use
it." Dr. O'Brien is the Kenneth Appel professor of psychiatry at the
University of Pennsylvania in Philadelphia, where he is also the director
of mental health research at Veterans Affairs.
Naltrexone has been used for some time to treat heroin addiction, but
the newly available sustained-release formulation is more accessible and
is also effective in treating alcoholism, he said. "This formulation is
easy to use, nontoxic, and not damaging to the liver," Dr. O'Brien
said. "HMOs are starting to cover treatment with depot naltrexone because
they realize it's cost-effective.
For alcohol-dependent patients, alcohol consumption interacts with the
dopamine system in a manner similar to that of opioids, Dr. O'Brien
said. Naltrexone blocks opiate receptors and therefore reduces alcohol
cravings. However, of the 20 million alcoholics in the U.S., only 5% are
treated with naltrexone.
This low rate of treatment reflects American attitudes that alcoholism
"is a disease of willpower," Dr. O'Brien said, noting that in Europe
and Australia, naltrexone is routinely given to alcoholics. He added that
naltrexone should be given in conjunction with supportive therapy, such
as counseling, cognitive behavioral therapy, or therapy from self-help
groups such as Alcoholics Anonymous.
Cravings typically subside within a few days of treatment, with
sufficient recovery six months after treatment that some physicians withdraw
treatment at that point. However, when naltrexone is discontinued,
cravings typically return three months later, Dr. O'Brien said, comparing
maintenance therapy with naltrexone to antihypertensive therapy.
Other medications that block craving include bupropion, used in smoking
cessation; the experimental agent rimonabant, used to treat both
excessive eating and smoking cessation; and acamprosate, which is also being
used to treat the cravings of alcoholism.
Two experts expressed confidence that these agents will address a need
in addiction therapy.
"Eventually we will have agents that help to maintain people off drugs
and alcohol after they have quit," Eric Collins, MD, told Medscape,
adding that the trend is to seek specific agents to address specific
addiction issues. These agents represent "a promising new strategy." He is
an assistant professor of psychiatry at Columbia University in New York
City.
"There will be certain subgroups for which one drug or another will
work," David Baron, DO, told Medscape. He is the chair of psychiatry at
Temple University in Philadelphia, Pennsylvania. Dr. Baron agreed that
tailoring the therapy to the patient is the most likely way in which
physicians will use these agents. Therapies to effectively address specific
craving "are right on the edge of becoming a standard treatment of
choice," he said. "We're not that far away from identifying which patients
will respond."
APA 157th Annual Meeting: Abstract NR451. Presented May 4, 2004.
Additional reporting by Charlene Laino.
Reviewed by Gary D. Vogin, MD
Member
Join Date: Apr 2004
Location: Somewhere Ca
Posts: 26
Could prove to be very useful. I believe what was said about docs not treating alcoholism because they believe it is a "disease of willpower" is is sadly...true. They need to be educated, and often it is up to us to do that. Thanks for posting this.
Are these little pictures under your name you?
Are these little pictures under your name you?
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