A new Yale study has identified a drug that may significantly reduce the intensity of heavy drinking among young adults.
The study found that participants reduced their drinking habits by roughly one drink per instance of consumption while on the drug — Naltrexone, an opiate inhibitor — potentially caused by the decreased “buzz” felt when drinking. The drug did not affect frequency of consumption.
“Young adults are generally more willing to consider reduced-drinking goals than quitting drinking,” said Stephanie O’Malley, professor of psychiatry at Yale and lead author of the study. “We tried to meet people where they are, and where they might want to make changes in their drinking.”
Researchers looked at 140 university-age men and women who frequently drank more than four drinks in a given night in order to identify the best way to help young adults “mature out” of heavy drinking. Though they acknowledged that binge drinking during college may be inevitable for some, the researchers looked for ways to make sure that students did not continue their unhealthy habits into their late twenties and beyond.
The study focused particularly on harm reduction rather than drinking cessation. O’Malley said she thought this model would best work with college students who may not want to completely quit drinking, but do want to make some changes.
In this focus on harm reduction, the study is particularly innovative, said Reid Hester, director of the research division of Behavior Therapy Associates, LLC — a New Mexico-based healthcare firm — who wrote a commentary on the study.
“This is one of the few studies in the United States to demonstrate the drug’s effectiveness with people who are heavy drinkers but not alcohol-dependent. And that is huge,” said Hester. “There are four times as many heavy drinkers as there are alcohol-dependent people, and the rate of alcohol dependence is decreasing while heavy drinking is rising.”
He added that, in contrast to alcoholics, who may need to make lifelong commitments to change their drinking habits, heavy drinkers can benefit from time-limited, focused help.
Naltrexone works as an opiate inhibitor, meaning that it blocks certain receptors in the brain that are stimulated by opioids wand alcohol, so that not all of the effects of alcohol are felt while on the drug. O’Malley attributed part of the reduction in alcohol use among participants to a decrease in the pleasure gained from the alcohol, leading to a decrease in interest in continuing drinking.
Clinical studies have recognized the effectiveness of the drug on alcohol use in a wide variety of manners, said Raymond Anton, professor of psychiatry and behavioral sciences at the Medical University of South Carolina. Naltrexone causes less intense craving, less pleasure activation and it decreases the “buzz” of alcohol, causing instead a more direct depressant quality.
“We see that lack of stimulation in a laboratory setting where they are getting a dose of alcohol with Naltrexone versus a placebo,” said Anton. “When they’re offered up to eight drinks afterwards, they actually drink less and have less stimulation.”
The drug is coming back into the mainstream after decades of relative obscurity due to bad timing with a patent from the pharmaceutical company DuPont, said Anton. Right as DuPont was beginning to advertise the drug as an alcohol inhibitor rather than an opiate addiction reliever, the patent expired and the drug lost favor.
While participants on Naltrexone, on average, consumed approximately one fewer drink for every instance of consumption, the study also found that Naltrexone produced additional benefits. Participants taking the drug instead of the placebo were 12 percent less likely to report that their schoolwork suffered in the time period, 16 percent less likely to pass out, 8 percent less likely to miss work or class and 19 percent less likely to have blacked out in the study’s eight-week time period.
The next step in this line of research, O’Malley said, is to explore similar relationships between drugs used to treat addictions and other related drugs. O’Malley is currently completing a study on whether Varenicline, an anti-smoking drug, may have an effect on alcohol use. If this is the case, then the study would suggest a stronger degree of inter-relationships between various dependencies and addictions.
Over 1,800 college students between the ages of 18 and 24 die each year from alcohol-related causes, according to the National Institute of Alcohol Abuse and Alcoholism.
Correction, March 3: A previous version of this article incorrectly stated that Behavior Therapy Associates, LLC was based in Nebraska. It is based in New Mexico.