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Naltrexone: The answer to alcoholism?

Anyone who has had alcohol problems knows that the best and perhaps only way to recover from alcoholism is to completely abstain from the substance. So it may come as a surprise to know that there are people like a certain Mrs. M who managed to overcome their addiction and still drink alcohol with an amazing amount of control.

Mrs. M is a former alcoholic from Scotland in the United Kingdom who beat addiction to lead a normal life and yet can drink a good amount of alcohol without relapsing, or even becoming tempted to do so, to her old drinking habit. Her secret is a prescription pill known as naltrexone. This drug interrupts certain brain pathways that alcohol uses to release endorphins.

The effect of naltrexone is best described by another former alcoholic who is taking the said pill, Matt. According to him, “With naltrexone, it’s weird. You drink and you feel the effect of the alcohol but it doesn’t have the magic.”

Basically, naltrexone prevents the release of endorphin which results to a weaker urge to use alcohol and without the craving for the substance, a former heavy alcohol drinker can use it with control.

The use of naltrexone as a treatment for alcohol addiction is known as the Sinclair Method. It was named for scientist David Sinclair, who was the first to discover the effect of the drug claiming that it had a 78% success rate. Success here is measures either as total abstinence or the ability to control alcohol intake within normal limits.

However, while Sinclair can identify around 76 clinical trials proving the safety and efficacy of the Sinclair Method, the general community of alcoholism professionals still doesn’t recognize it as a treatment method. There are even some that don’t even know it.

The main reason behind this apparent indifference for the Sinclair method stems from its main directive that to overcome alcoholism, an individual must continue to drink. Following this method, an alcoholic takes naltrexone on the days he or she drinks alcohol with the result that his or her cravings diminishes. This, in turn, leads him or her to drink less until he or she eventually stops to drink. Most alcohol addiction professionals are not comfortable with this setup, as most tend to put more weight on complete abstinence.

Even with the rejection from the alcoholism treatment community, Naltrexone was actually in 1994 endorsed World Health Organisation in 1994 and in 1999 by the US Food and Drug Administration in 1995. The drug was also recommended by the American Medical Association generalized alcoholism treatment in 2006.

As Sinclair and a colleague named Roy Eskapa puts it, the alcoholism treatment community does not recognize naltrexone and the Sinclair method because it presents a threat to the multibillion dollar rehab industry. According to them, “There is little money to be made from giving an outpatient a prescription for naltrexone.”

In defense of the treatment community, a British consultant psychiatrist named Dr. Jonathan Chick said that while the drug can help to reduce the brain-stimulating effects of alcohol, it still is not a universal solution that can be given to all alcoholics. “We prescribe it to people who continue to drink in the hope that it will reduce the frequency of the sessions where they drink to excess and put themselves at risk. If they take naltrexone before they drink, they can have some satisfaction from the taste and some mental effect from the alcohol but report that they don’t want to carry on and ‘lose control’ of the amount they drink. Unfortunately, quite a lot of our patients don’t take it as prescribed,” he said. Dr. Chick also noted on it is really primarily the Sinclair Method’s sanction of continued drinking that makes it rather unpopular among clinicians.

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