Why is alcohol such a hard drug to kick? Researchers think it’s due to the chemical changes each sip can cause deep inside the cells of the brain. In a study in Science Translational Medicine, researchers discovered that alcohol touches parts of the brain called the nucleus accumbens and orbitofrontal cortex, which are both involved in a sense of reward. When these brain parts are touched, they release chemicals associated with pleasure and bliss. That suggests that the relaxing sensation alcohol can deliver is chemically driven.
Since alcohol’s benefits start with chemical changes, it makes sense to look for ways to use chemicals to make alcohol recovery possible. One such solution, acamprosate, might be just right for you or someone you love.
Traditionally, it’s been difficult to help people to leave alcohol behind for good. In fact, some of the most relied upon treatments for alcohol don’t help every single person that needs help. For example, in a study in the journal Alcohol and Alcoholism, researchers found no difference in alcohol relapse rates among two groups of people. One group went to support group meetings in the Alcoholics Anonymous (AA) model, and the other did not. Studies like this seem to suggest that even AA, which is touted as the best way to treat an alcoholism issue, can’t help every person on its own.
Acamprosate is designed to boost the efficacy of existing treatments, providing people with the breathing room they need to leave alcohol behind so they can pay attention to the benefits of sobriety.
In the early days of recovery, people with an alcoholism habit struggle to avoid a return to drink. Everywhere they look, it seems like alcohol is available. They can just walk into a store to buy it, or they may even have leftover alcohol at home they could sip on. Lapsing back into alcoholism is so easy and hard to resist.
People who do take that first sip often find that it’s hard to stop drinking and start paying attention to recovery. When they start drinking again, they may stop going to meetings and they may start skipping therapy appointments. They just can’t pay attention to recovery when they’re drinking. The alcohol seems to take over.
The key, say some researchers, is to stop people in the early stages of recovery from taking that first sip. If they can avoid that first relapse, the thinking goes, they’ll stay in therapy and support groups for longer. When they do that, they’ll pick up the lessons that can help them to make meaningful sobriety changes.
That’s what acamprosate is designed to do. According to a study in the Journal of Psychopharmacology, this medication helps to support early abstinence. It doesn’t help people to stop drinking once they have started, so it’s not meant to keep a slip from turning into a relapse, but it can make that slip a little less likely. That could be a huge help to people who want to leave alcohol behind for good.
An overview article in American Family Physician suggests that acamprosate has been used in Europe since 1989, and even though that’s plenty of time in which researchers could have done work to determine how the drug works, those definitive studies haven’t yet taken place. That means researchers don’t know exactly why this drug helps people with alcoholism.
It is known that the drug attaches to calcium channels in the brain, and it modifies the movement of a key chemical that’s associated with pleasure. When that change is in place, a drink of alcohol just might be a little less rewarding. The cascade of signals that indicate pleasure are a little muted and muffled. That change could keep people from drinking, just because it doesn’t seem like a great thing to do.
Acamprosate doesn’t last for very long, so people who are using this medication for recovery need to keep taking the drug every single day, right on time. Skipping a dose stops the effect, and that could make a relapse more likely. So people with alcoholism who use this medication will need the willpower to remember to take the drug. For some, that could be an issue. If they know skipping the drug means enjoying alcohol, they might be tempted to skip doses all the time. They’ll need motivation, either from a residential treatment facility or from their families, to stay on course with treatment.
Those who use the drug may find that it’s both effective and very safe. Research cited by the Substance Abuse and Mental Health Services Administration suggests that even very high doses aren’t associated with overdose problems, and the liver doesn’t metabolize the drug. That’s good news, as many people with advanced alcoholism have very damaged livers due to the corrosive action of alcohol on the liver. Long-term exposure can make this organ work poorly. Since acamprosate isn’t metabolized by the liver, it’s safe to use even in people who have liver difficulties.
In one such study in Neuropsychopharmacology, researchers found that acamprosate helped to reduce the impact of environmental cues in alcohol-addicted rats. This is an important study in which researchers made rats think of alcohol when they were exposed to the scent of an orange. When these rats were given the medication and exposed to the scent, they were less likely to drink. That result could suggest that the drug could help people to overcome urges to drink, too.
A separate study in Clinical Therapeutics found that the rates of abstinence in people who took acamprosate ranged from about 18 to 61 percent. That might seem like a low rate, but people taking a placebo drug had abstinence rates of only four to 45 percent. It’s clear that, for some people, the medication means the difference between fending off the urge to drink and falling back into old habits.
If you’re struggling with an alcoholism issue, your treatment plan might include a variety of steps, including:
A comprehensive plan like this attacks your alcoholism issue on all sides, providing you with the best opportunity to really see where your alcohol habit came from and what you’ll need to do to recover.
Acamprosate might also play a role for you if you just can’t stop drinking long enough to allow that therapy to work. With acamprosate, you’ll have the chance to really improve and get involved in your care, and that could make all the difference in your chances of long-term recovery.
If your team includes the medication in your treatment plan, you’ll work with them on how often to take it and how long to take it. When you’re feeling stronger, you’ll work with the team on eliminating the drug from your day-to-day life.
If you have questions about how alcoholism treatment works, or how recovery from alcoholism might be complicated by a mental illness you have right now, we can help. Just call us to find out more about the treatment options open to you. We’re here to help around the clock with any questions or concerns you might have. Please call and we’ll tell you more.
Integrated Treatment of Substance Abuse & Mental Illness