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Alcohol is the most commonly used addictive substance in the U.S. – almost 18 million people suffer from abuse or dependence. But can a new technique allow those addicted to alcohol to “drink themselves sober”?
Naltrexone is commonly prescribed to reverse opiate overdoses, and according to studies, it may also block the intoxicating effects of alcohol. In the Sinclair Method, alcoholics continue to drink, but they take Naltrexone beforehand. Psychiatrist Dr. Domenick Sportelli and Psychologist Dr. Adi Jaffe join The Doctors to provide their differing perspectives on Naltrexone as a treatment for alcoholism.
“When someone drinks alcohol, not only do they get drunk but they have a euphoric experience,” Dr. Sportelli explains. “And the euphoric experience is based on endogenous opiates.” These chemicals are produced by our own brains. Naltrexone offers the possibility of blocking the endogenous opiates – making getting drunk much less rewarding.
The catch is that Naltrexone’s effect relies on the user drinking alcohol. “We’re sitting here saying ‘Alcoholic – take a drink!?’ It’s difficult to conceive,” says ER Physician Dr. Travis Stork.
Dr. Jaffe agrees, “It is. And a lot of people feel that if you’re going to take care of alcohol addiction, you have to be willing to quit forever.” However, with the Sinclair Method, the patient initially continues drinking. “It slowly pares away the pleasure effect from the experience of drinking. People report that, when it works for them, they just don’t want to drink as much.”
Only 10 percent of people with alcohol problems go into treatment of any kind, and Naltrexone may encourage more drinkers to try to stop. Dr. Jaffe says, “This is something you can try relatively easily with a prescription and a therapist or a psychologist.”
Dr. Sportelli cautions, “You’re relying on this conditioning and extinction. And the only way that that works is if the person is willing to take that pill every time before they take that drink … You’re asking someone addicted to the euphoric experience of getting drunk to take something to stop that euphoric experience.”
Dr. Jaffe suggests it can be a first step for heavy drinkers to move toward quitting. “I think the important thing is patient screening and close monitoring,” adds Dr. Sportelli. He doesn’t believe it’s enough to send an alcoholic home with a bottle of pills.
Both doctors agree that for some patients, this treatment can help. And Dr. Stork adds, “I always say, the more options the better! Just be sure that the option you’re using is right for you.”