Naltrexone: Real Medicine for Problem Drinking

Posted: May 29, 2017 6:00 AM
In the US, 7% of the population 18 and older has a drinking problem. Fully a quarter of the population reports drinking heavily, or drinking more than they want. The damage that alcohol and other drugs can do to lives is immeasurable. And that’s just thinking about direct impact.
Don’t forget the toll abuse takes on loved ones and innocent bystanders who get caught in the crossfire. Fortunately, we have a new tool in the arsenal, and when you couple it with a desire to get better, the results can be startling. But, before we go down that road, it helps to ask—who needs help?

What Is A Drinking Problem?

Like so much in this world, everyone thinks they have a firm grasp on what a drinking problem looks like—but few people are able to define it. Little surprise, then, that of all the alcoholics in the world, 95% think they don’t have a problem. Recognizing an issue in yourself is one of the hardest things to do. So let’s take a moment to ask, just what makes for a drinking problem? There are definitions out there, but they’re slippery. For instance, the Department of Health and Human Services defines moderate drinking as up to a drink in a day for women, or two drinks in a day for men. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as five drinks or more for males, or four drinks or more for females, within a period of a couple hours. There’s a lot of space between those two definitions. Generally speaking, if you binge drink five or more times in a month, that’s considered an alcohol problem. But if you never exceed three drinks in a day or seven in a week for women—four drinks in a day, 14 in a week for men—you’re considered low-risk. Again, there’s a lot of wiggle room between all these alcohol-by-unit measurements. And they’re entirely too broad. I’ve known people who could drink ten beers and show no ill effects, nor need a drink later. And I’ve known people who start to get antsy if they don’t have their half a glass of red wine each evening.

Do You Want To Solve The Drinking Problem?

Let’s be clear: Simply knowing there’s a problem is merely the first step. In order to get better—to avoid dangerous, impaired decisions, or the health consequences that come from years of alcohol abuse—one has to want to get better. Telling someone you love that they need help, by itself, may not help. In fact, it can often backfire. But if you can show someone you care about (including yourself) that they do indeed have a problem, hopefully, they’ll want to get help themselves. Because that’s the key to everything. Without the will to get better, there’s no hope of any solution sticking. You have to want to curb your drinking, before you can.

Drinking Problems Vs. Will Power

Until very recently, anyone with a drinking problem—or any sort of substance abuse problem—had to rely on willpower alone. Of course, there are other ways to assist. Alcoholics Anonymous meetings are a godsend for some. Treatment centers—outpatient or, in extreme cases, in patient—may also help. Depending on the cause of the substance abuse, counseling can also help. But, when you boil it down, those are just ways to prop up your own innate willpower. At the end of the day, you have to be able to sit alone in your room and just say, “no.” But finally, we’ve got reinforcements. There’s a drug, naltrexone, that can help. Originally developed to treat autoimmune disorders, it turns out naltrexone curbs the centers of the brain that are affected by alcohol and opioids. In effect, it takes the buzz out of drinking. When you get drunk, it takes away the most pleasurable parts of the experience. So, those who use naltrexone find themselves less attracted to alcohol—or other drugs. Naltrexone immediately reduces the euphoria of drinking and the negative effects of alcohol withdrawal. After 6-12 months’ regular use, people typically discontinue naltrexone and find that their cravings for alcohol have disappeared. When combined with another drug, acamprosate—which helps reduce cravings—those dealing with substance abuse find it much easier to say no to that next drink. Yet, despite plenty of evidence that these drugs work, lots of doctors are unaware of them, and even fewer use them. So if you or someone you love suffers from substance abuse—especially alcohol abuse—talk to your doctor about naltrexone and acamprosate. Both are available only via prescription, so you need a doctor who is on board. Normally, I’m not a fan of drugs—in most cases, we overprescribe drugs and underutilize safer, more natural solutions. But in this case, drugs themselves are the problem. Naltrexone and acamprosate are much safer than substance abuse, and hopefully are only needed for a limited period. Alcoholism and substance abuse are hard, sticky problems. Breaking the cycle of abuse isn’t easy. And many lives are lost because of it. But, if you or someone you love is eager to give up this destructive pattern, naltrexone and acamprosate can make the job much easier. It’s not an instant cure, mind you. But, without doubt, it’s an enormous help. With these treatments, you can give your willpower a much-needed assist.