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Scripps Research Study Finds Drug Effective In Curbing Cravings For Alcohol

Evening Edition

Above: There are an estimated 18 million problem drinkers in the United States. Frequent heavy drinking takes a major toll on one’s health and wellbeing. KPBS Health Reporter Kenny Goldberg says there are different opinions on the best way to break dependence on alcohol. But new research indicates a drug long used to treat seizures can be an effective tool.

Aired 11/20/13 on KPBS News.

Could a pill help heavy drinkers stay on the wagon? New study from Scripps Research Institute suggests a drug long used to treat seizures could be an effective element of treatment.

— There are an estimated 18 million people with drinking problems in the United States. Frequent heavy drinking takes a major toll on one’s health and wellbeing.

There are different opinions on the best way to break dependence on alcohol. But new research indicates a drug long-used to treat seizures can be an effective tool.

Kathy Selman is a go-getter. After years in real estate, she helped start a women’s networking group.

Kathy Selman successfully quit drinking after taking part in a clinical trial involving gabapentin at The Scripps Research Institute.

These days, Selman doesn’t drink at all, not even socially. But for seven years, she couldn’t get through a day without having four glasses of wine.

"A lot of it’s a fog," Selman recalled. "You know, you go through regret, remorse, guilt, embarrassment. You have no confidence, you lose your self-esteem. It was awful … it’s devastating."

But what if there were a pill that could help heavy drinkers kick the habit?

New Research

Scripps Research Institute psychologist Barbara Mason has just published a study that suggests the drug gabapentin could fit the bill.

Gabapentin may reduce cravings for alcohol.

Gabapentin is FDA-approved to control seizures for people with epilepsy. For years, doctors have also prescribed it to treat alcohol dependence. But gabapentin hasn’t been tested in a large, randomized clinical trial for that purpose.

Until now. Dr. Mason’s study involved 150 long-time alcoholics who averaged 40 drinks a week. Half were given gabapentin, and half got a placebo.

The Pearson Center for Alcoholism and Addiction Research at the Scripps Research Institutes conducted a clinical trial using the drug gabapentin, which may reduce cravings for alcohol.

After 12 weeks, the rate of people who abstained completely from alcohol was four times higher for those taking gabapentin than for those taking a placebo. What’s more, those results were sustained for months after people stopped taking the drug.

"And these effects are as large, or larger, than the FDA-approved treatments," Mason said. "But what’s important, is that gabapentin also had the beneficial effects on sleep, and mood, and craving. And it was found to be very safe and well-tolerated."

Psychiatrist Krista Roybal directs the Scripps Drug & Alcohol Treatment Center. It’s not affiliated with the Scripps Research Institute.

"People decide to get sober, it’s a huge accomplishment to make that decision. They go through detox, which may or may not be difficult, and then they’re expecting to feel good," Roybal said.

But as Roybal explains, people in the early stages of recovery often suffer from sleeplessness, depression and disabling anxiety.

Those painful symptoms can make it hard for alcoholics to resist taking a drink. That’s why she often prescribes gabapentin.

"And what I say to patients with gabapentin is, it’ll just amp it down, it’ll take the edge off," Roybal said. "It’s not a cure-all, but it really helps with the negative psychological effects."

Social Model Approach

But there is a school of thought that believes medical treatment for alcohol addiction isn’t the best approach.

For more than 50 years, the Fellowship Center in Escondido has helped thousands of men recover from addiction to alcohol and other drugs.

The Fellowship Center is based on the principal that people in recovery are best helped by others who have gone through the process themselves. This so-called "social model approach" is based on the principals of Alcoholics Anonymous.

Executive director Paul Savo said heavy drinkers don’t respond well generally to medical treatment for their addiction, where a doctor or other provider is in charge of the recovery process.

"They respond to a sense of understanding and connection," Savo said. "They respond to the fact that 'I’m an alcoholic talking with somebody who understands where I came from, and they know what I’ve been through.'"

Savo said there’s nothing necessarily wrong with the idea of a taking a pill for a short time to help stabilize someone who’s in recovery. But, he said, unless it’s lifelong, it’s only a small part of the recovery process

"We instill these lifelong, fundamental tools that allow a person to always fall back on certain things that they’ve done here, that reduce anxiety, that reduce stress, helps them get through the tough spots, without resorting to alcohol or drugs," Savo explained.

The Role of Medication

To be sure, addiction researcher Barbara Mason said, there are many pathways to recovery. She maintains her study shows gabapentin can be a big help.

Mason concedes neither gabapentin nor any other medication on the market is a cure-all for people who have been drinking heavily for years.

"You just don’t turn that ship around with a pill, you know, just a pill, in most cases," Mason said. "You really need to do work, and you know, that’s a personal part of the journey of recovery."

Kathy Selman was finally able to give up drinking three years ago, when she went through a different clinical trial at The Scripps Research Institute.

To this day, Selman doesn’t know if she was given a drug or a placebo.

Either way, she’s glad she kicked her habit.

"If I’d continued down that path, I don’t know where I’d be today," she said. "It’s pretty scary … it’s a very sobering thought."

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