An extreme craving for alcohol can dictate a person’s thoughts and behaviors, leading to alcohol use disorder and other health consequences.
But a new study from the Scripps Research Institute shows that craving alcohol can be medically controlled, and that's exciting for some treatment counselors. The study focused on apremilast, a drug that’s been approved by the FDA for topical use on psoriasis.
“We found that the individuals who were treated with apremilast reduced their drinking by more than half. And we found that the individuals who were treated with the placebo had no change in their drinking,” said Barbara Mason, a professor of medical medicine at Scripps Research.
Apremilast is trademarked Otezla. Along with treating psoriasis, a study on mice has shown it could also reduce the cravings for alcohol by inhibiting a molecule in the brain known as PDE4.
Scripps Research then conducted a clinical trial with 50 people with severe alcohol use disorder, commonly called alcoholism. Mason said after using Otezla, the test subjects simply didn’t want to drink as much.
“We had a number of comments like, ‘I just didn’t feel like drinking. I didn’t have the craving.’ People couldn’t quite put their finger on what was going on but they noted, within themselves, that urge to drink was absent,” Mason said.
People in the study had been consuming an average of five drinks a day. That was reduced to two drinks a day among the people who used Otezla.
Jim Dunford is the director of the McAlister Institute, a substance abuse treatment center in San Diego. He said he was very impressed by the Scripps study. He knows of no other drug that’s aimed at reducing alcohol use or has shown the same effectiveness among problem drinkers.
“The individuals all qualified as having severe alcohol use disorder, and they showed a significant reduction in drinking. And, like I said, these previous medications, they don’t show that kind of effect,” Dunford said. “This medicine also didn’t show any appreciable side effects.”
The use of drugs to reduce the craving for alcohol has not been emphasized by treatment professionals. Dunford said that’s too bad because 'medically assisted treatment,' as he calls it, should be a part of effective treatment.
“Craving is a key component of alcohol dependency,” he said. “People spend inordinate amounts of time thinking about it. And the idea of ‘I gotta have a drink’ basically starts to preoccupy them to the point where all the other things in their lives start to take second place.”
Dunford said the consequence of failing to treat alcohol use disorder was shown to him on the morning of his interview with KPBS, when a homeless man in his neighborhood died on the street.
“It was a guy that I’ve known on the streets for five years who was found dead, right next to the coffee shop where I go every morning. I see him almost every day and he died on the street from addiction,” Dunford said. “All of us, in that neighborhood, really liked ... And there he was.”
Barbara Mason, the director for alcoholism and addiction research at Scripps Research, said the next step is to test Otezla with a larger group of problem drinkers.
