Once a disease considered so intractable and untreatable that it often forced sufferers to live out there days in psychiatric facilities, great strides have been made to both address – and lift the stigma surrounding – alcoholism. And, increasingly, a host of new drugs are cropping up which claim to reduce cravings and address symptoms which often trigger or influence relapse behaviors. Anyone who follows this blog or and is familiar with our model of care knows that we don’t subscribe to approaches to addiction treatment that center on using one substance to help reduce dependence on another. Still, it is important to acknowledge the role that research and innovation are playing to help address addictive patterns and alleviate some precursors to drug seeking and cravings. The latest such development: research out of UCLA that suggests an anti-inflammatory drug primarily used in Japan to treat asthma could help positively impact alcoholic tendencies.
The UCLA study is the first to evaluate the drug, ibudilast, as a treatment for alcoholism. Study participants were given either the drug (20 milligrams for two days and 50 milligrams for the next four) or a placebo for six consecutive days. After about a two-week break, those who took the drug were switched to a placebo for six days, and those who were taking the placebo were given ibudilast. The researchers found that the subjects’ craving for alcohol was significantly lower when they were taking the medication.
The study also examined participants’ moods and reactions upon exposure to alcohol. Those in the study were asked to hold and smell a glass of their preferred alcoholic beverage but not drink it. Then, their reactions were recorded. Almost unanimously, subjects reported being in a better mood while they were taking ibudilast than when they were on the placebo.
The research evaluated 17 men and seven women who, prior to the study, reported drinking an average of 21 days per month and drinking seven alcoholic beverages per day when they drank. On the sixth day of each phase of the study, participants received an intravenous dose of alcohol — the equivalent of about four drinks —to test how the medicine interacts with alcohol and whether it can be safely administered when people are drinking.
“We found that ibudilast is safe and well-tolerated,” said Lara Ray, director of the UCLA Addictions Laboratory and the study’s lead author. “This medication can be safely administered, including when people are drinking alcohol.”
Side effects from the drug, which included nausea and some abdominal pain, were mild, and none of the participants dropped out of the study. The research is published online in Neuropsychopharmacology, and will appear later in in the journal’s print edition.
Researchers also evaluated the drug’s efficacy by looking at how well and how quickly participants could recover from a stressful situation. When the study began, the researchers asked participants to describe sources of stress in their lives. On the fifth day of each phase the study — when the participants were taking ibudilast and again when they were taking the placebo — researchers discussed those situations with the participants. The subjects’ moods improved much more quickly after hearing about their own stressful situations when they were taking ibudilast than when they received the placebo. The treatment seemed to especially help those in the study who had depressive symptoms, which are common in heavy drinkers of alcohol. The drug appears to reduce the pleasurable effects of alcohol.
Chronic alcohol consumption elevates brain inflammation in animals, and earlier research showed that ibudilast was effective in reducing rats’ alcohol consumption. But it wasn’t a foregone conclusion that it would also be effective in humans.
Some drugs that have shown promise in animal testing caused too many negative side effects in humans to be approved by the FDA and put into mainstream use. Currently, only four drugs have been approved to treat alcoholism in humans, and most have been only modestly effective.
The UCLA team plans to next test the drug on heavy drinkers who expressly want to quit drinking. (Those in the current study were not working towards abstinence. They also plan to look more closely at how ibudilast reduces brain inflammation.
While we’re not a believer in any “silver bullets” to treat drug or alcohol abuse and hold that fundamental life and spiritual changes are typically needed to achieve long-term happy, healthy sobriety, we certainly support innovation. And, things that can be used as complimentary approaches to multi-faceted, integrated treatment might prove useful to some. Just don’t look to a pill to solve all of your problems and replace the hard work of recovery.