The challenges of creating more ways to treat alcoholism

Nov 22, 2022

A recent article published by the Washington Post, authored by Katherine Ellison, discusses the difficulties in the development, promotions, and accessibility of new medications for alcohol use disorder.

According to the Centers for Disease Control (CDC), alcohol abuse is linked to over 140,000 deaths in the U.S. each year, while data released by the Canadian Institutes of Health Research (CIHR) shows that in 2017, alcohol use has led to over 18,000 deaths and 105,000 hospitalizations in Canada alone.

According to George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), getting promising new medications to doctors and their patients has its own specific challenges, including the lack of awareness by doctors, funding decisions by the pharmaceutical industry, and the stigma surrounding alcoholism.

While medication can play an important role in combating alcohol use disorder, research shows that less than 2% percent of individuals affected by alcohol addiction take medication for this condition, compared to 13.4% of individuals affected by opioid addiction.

Current treatments for alcohol use disorder are limited, with only three medications having been approved in Canada by Health Canada, which include disulfiram, naltrexone, and acamprosate. Similarly, in the U.S., only several medications have been approved by the FDA for alcohol use disorder treatment, including gabapentin, baclofen, topiramate, and ondansetron. In addition, some of the problems associated with existing FDA-approved medications include their limited efficacy.

In recent years, psilocybin, a naturally occurring psychedelic prodrug compound produced by many species of fungi, has been increasingly examined as a potential treatment for several medical conditions, including alcohol use disorder.

New research published by JAMA and carried out by researchers at NYU Langone Center for Psychedelic Medicine, showed that participants diagnosed with alcohol use disorder who received two doses of psilocybin reduced their alcohol consumption by 83% within eight months, compared with 51% of participants who received a placebo.

In addition, 25% of participants who received psilocybin stopped drinking altogether, compared to 9% of participants who took the placebo. The molecular mechanisms of action of psilocybin are still undergoing research, but researchers hypothesize that it augments the beneficial effects of psychotherapy.

In contrast to medications for other common conditions such as depression, cancer, and erectile dysfunction, many doctors are unaware of medications used to treat alcohol use disorder. Furthermore, another issue is the lack of interest in furthering the research of potential medications to treat alcohol use disorder by large pharmaceutical firms.

“We may have a current epidemic of opioid use, but our alcohol use disorder has been of epidemic proportions for thousands of years,” said Dr. Susan E. Bergeson, editor-in-chief of the Alcoholism Treatment Quarterly and a professor of women’s health at Texas Tech University Health Science Center, in her interview with the Washington Post.

“I think the pharmaceutical firms must be interested in this market and are just waiting for the right approach with lower risks,” she added.