I heard on the radio this morning that there are animal trials underway for a new injectable drug they referred to as a "shot against alcoholism." What it actually is (and I haven't looked into the actual study) is not like a vaccination, but probably more similar to a "depot" drug, akin to something like DepoProvera for birth control: a drug you can take orally every day or get an injection (this new drug is 6 months, from what I understand) which maintains its effect for an extended period of time. It sounds like what they're working on (in Chilean mice, so far) is similar to Antabuse (disulfiram) which is a pill you take every day as a deterrent to drinking. If you drink while it's in your system, it produces horrible sickness (think "worst hangover you can imagine") including significant nausea and vomiting.
So why would something like that work? You don't have to take it if you don't want, then you'd be able to drink without consequence. It's a form of aversion therapy (akin to Schick-Shadel) which has a couple common uses. First is people who are self-motivated enough to quit but for whom other attempts have failed. They may realize, most of the time, that they shouldn't drink, but they do at times of stress, in the evening after a hard day, etc. They can reliably take their pill every morning, knowing that they shouldn't drink, then when an urge comes about they have a physical barrier to overcome the thoughts like "one drink will be okay" that lead to relapse. It doesn't always work, though; they interviewed one of these patients on the radio who actually planned to stop taking it a few days before an event (e.g. Super Bowl party) but always The other subset would be people who have legal factors involved such as DUI, probation, etc. and who can't be depended upon to stay compliant. They will be more closely followed by health care providers or probation officers, sometimes visiting daily to observe their dose.
Either of these types of people can be lost to follow up or fail to take their pill every day so they can have a drink. This new idea for a 6-month injection eliminates that day-to-day variability in compliance. You can't think "I'll just not take it today so I can drink tomorrow" because the drug is in your system for way longer than that. It also provides a solution to the huge costs and personnel requirements with daily check-ups in the cases of probation and the like. So it seems like a perfect solution! Though, as now with Antabuse, it would probably still be reserved for refractory cases of alcoholism, that is, those people who have tried and failed the more traditional treatments.
I can see one potential problem, though. It isn't unique to a long-acting version, but as with any addiction treatment, there is more than the physical-chemical process. I could easily see how courts might just mandate this drug's use as part of sentencing for certain cases (DUI, repeat intoxication offenders) and leave it at that. However, you aren't truly treating an addiction if you stop the physical behavior but don't address the psychological, emotional, and mental changes involved in any drug or alcohol addiction. You shouldn't give someone this shot and send then out the door the same way that you shouldn't give methadone treatment (substitute/replacement for heroin/opiate addiction recovery) without providing counseling, support groups, 12-step programs, and other resources. That said, though, as long as a holistic approach to alcoholism treatment isn't lost in the presence of a novel, convenient drug/delivery method, this could promise to be a beneficial solution, both financially (with no need for daily monitoring and fewer repeat offenses) and in terms of treatment success (resulting in fewer losses/injuries/deaths), for people who can't make those last steps to completely cutting out alcohol. It may also be a feasible alternative to repeat offenses or incarceration for those with DUI history as a contingency of driver's license reinstatement in certain cases. It isn't into human clinical trials yet, so it's at least 4-5 years down the road, but it will be interesting to see if this drug is successful and how it could potentially improve alcoholism treatment.
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