Injection to Prevent Binge Drinking

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In this case I am talking about Naltrexone, the medication that blocks the effects of drugs known as opioids (a class that includes morphine, heroin, cocaine or codeine). It competes with these drugs for opioid receptors in the brain. It was originally used to treat dependence on opioid drugs but has recently been approved by the America Food and Drug Administration (FDA) as treatment for alcoholism.

In clinical trials evaluating the effectiveness of naltrexone, patients who received naltrexone were twice as successful in remaining abstinent and in avoiding relapse as patients who received placebo.

Some of us may experience a bit of over-indulgence during the festive season, but for others however, alcohol is a massive destructive problem in their lives and dealing with alcohol addiction is a persistent obstacle.

In those cases, the best defence against alcoholism could be to get an injection. At least, that is the line of thinking behind a new study that looked at monthly injections to battle alcohol abuse.

Sobering thoughts

40 per cent of all road deaths during Christmas and New Years involve at least one alcohol-impaired driver, compared to 28 per cent the rest of the year.

Naltrexone is a once-a-day prescription medication that works in the brain to curb the urge to drink and reduce the amount consumed if heavy drinkers do give into the craving.

Naltrexone needs to be administered on a daily basis — essentially committing to sobriety every day. That's not so easy for people who deny they have a problem or who know they do but are nonetheless looking forward to the annual office bash.

In 2006 FDA tried to address this specific problem by approving a new form of naltrexone in which tiny grains of the drug are coated in a biodegradable polymer. When a single dose is then injected the coating will dissolve slowly, releasing just enough of the drug to keep you away from the bottle for a full month.

Saving lives

Dr. Sandra Lapham of the Behavioural Health Research Centre of the Southwest, in Albuquerque, New Mexico, worked with the manufacturer of the slow-release naltrexone to reanalyse data from previous studies. Dr. Lapham specificalle searched for findings that focused on the drug's effectiveness during 10 US holidays. Comparing patients who received the naltrexone shots to those who received placebos, she found:

• a reduction in the number of days the subjects drank
• and — on those days they slipped — in the number of drinks they consumed,
• and a smaller percentage of sessions classified as binge drinking sessions

Dr. Sandra Lapham’s study clearly supports the idea of a seasonal injection.

Naltrexone was introduced in the UK in 2001 with a lot of controversy and it is only one component of a programme of treatment for alcoholism including counselling, help with associated psychological and social problems and participation in self-help groups. In two studies where naltrexone was shown to be effective, it was combined with treatment from professional psychotherapists.

Alcoholism is a serious and extremely destructive addiction; it is also one of the most difficult addictions to overcome purely because of the temptation of alcohol being all around – specially in a country like Britain with its Pub-Culture.

Like any mainstream pharmaceutical naltrexone have its side-effects. Luckily the side-effects are not life-threatening. In the largest study, the most common side effect of naltrexone affected only a small minority of people and included the following: nausea (10 per cent), headache (7 per cent), dizziness (4 per cent), fatigue (4 per cent), insomnia (3 per cent), anxiety (2 per cent), and sleepiness (2 per cent).

These side effects were usually mild and of short duration. As treatment for alcoholism, naltrexone side effects, predominantly nausea, have been severe enough to discontinue the medication in 5-10 per cent of the patients starting it. For most other patients side effects are mild.

One serious possibility is that naltrexone can have toxic effects on the liver. Blood tests of liver function are performed prior to the onset of treatment and periodically during treatment to determine whether naltrexone should be started and whether it should be discontinued if the relatively rare side effect of liver toxicity is taking place.

There are growing concerns that a new generation of drivers do not regard drink-driving as taboo.

A final thought

In 2007 the UK was criticised for falling behind other European countries in road safety performance, amid a rise in the number of young motorists involved in accidents while under the influence of alcohol.

Road safety campaigners have urged the government to introduce random breath tests, which they say will heighten drink-drivers' fears of being caught. The introduction of roadside tests in New South Wales, Australia, halved the drink-drive death rate. Figures from the European Transport Safety Council (ETSC) showed France had reduced road deaths by a third between 2001 and 2005, compared with a 7 per cent drop in the UK.

Always drink responsibly and never drink and drive. Those are the simple rules that can make a tremendous difference.

Sources:

‘An Injection to Cure Holiday Drinking?’ by Jeffrey Kluger, published online 18/12/08, time.com

‘Drug misuse – naltrexone’ published online, nice.org.uk

‘Drivers face big cut in drink limit and random tests’ by Dan Milmo, published online 15/07/07, guardian.co.uk