The Past and Future of Research on Treatment of Alcohol Dependence PMC

Some programs offer you a chance to live in a facility where you can have more intense treatment. Alcohol use disorder has also been linked to a higher risk of several cancers, including colon, breast, oral, liver, and throat cancers. A 2017 research review did not find that this therapy was more effective than other forms of relapse prevention. Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California. Verywell Health articles are reviewed by board-certified physicians and healthcare professionals.

An allostatic state can be defined as a state of chronic deviation of the reward system from its normal (homeostatic) operating level. Allostatic load has been defined as the “long-term cost of allostasis that accumulates over time and reflects the accumulation of damage that can lead to pathological states” (McEwen 2000). Although the concept of allostatic state has not received much attention, the argument here is that alcoholism reflects largely a movement to an allostatic state, often before sufficient pathology has ensued to produced allostatic load sufficient for physical pathology (Koob and Le Moal 2001). Perhaps more relevant to the present thesis are studies showing that intermittent alcohol exposure sensitizes withdrawal of anxiety-like responses and that administration of drug treatments during withdrawal from the first and second alcohol cycles blocked this sensitization of withdrawal (Knapp et al. 2004). Diazepam, flumazenil (a GABAA receptor partial agonist), and baclofen (a GABAB receptor agonist) blocked the sensitization of withdrawal, consistent with a within-system neuroadaptation (Knapp et al. 2004, 2005, 2007; see above).

Anti-addictive actions of an iboga alkaloid congener: a novel mechanism for a novel treatment

To support this hypothesis, a holistic view of alcoholism will be presented with the following arguments. A negative emotional state is a common presentation in most alcoholics during withdrawal and protracted abstinence. Compulsivity observed in alcoholism has an important negative reinforcement component that perpetuates alcoholism.

Herbal Approaches to Alcohol Dependence

Many counselors have minimal training, and the turnover among treatment program staff is more than 50 percent annually (McLellan and Meyers 2004). There is a constant shortfall of funding so programs are unable to invest in infrastructure such as electronic medical records (McLellan and Meyers 2004). Although program staff members often are dedicated and hard working, this environment makes providing modern treatment extremely challenging if not impossible. In addition to herbal supplements, herbal teas can provide soothing support in alcoholism recovery.

Recovery Path: What Herbs Are Good for Alcoholism?

In addition there is significant evidence related to the role of the genetics of bitter receptors (TAS2R) and… As with many other OTC herbal supplements, there’s little convincing evidence that the aforementioned supplements are clinically effective treatments of alcohol dependency. There have been some scientific studies conducted, but a majority involve animal models and show modest findings that rarely translate into conclusive human trials. herbs to curb alcohol cravings The primary danger of these supplements in those with alcohol dependency is not necessarily knowing the drug—drug interaction potential or side effects. If asked about herbal treatments for a drinking problem, it is advisable to recommend speaking with a professional rather than self-treatment with over-the-counter supplements. This is the fourth installment in a series of posts on non-pharmacologic approaches to alcohol and drug abuse.

  • Treatment outcomes for patients treated with naltrexone, topiramate, SSRIs, and ondansetron can be improved by targeting those treatments toward specific alcohol subtypes and genetic markers.
  • Supplementing with thiamine, as well as other B-vitamins, such as vitamin B12 and folate, can help replenish nutrient levels and promote overall well-being.
  • More specifically, alcohol withdrawal reliably produces anxiety-like responses in animal models that can be reversed by CRF receptor antagonists (Koob 2008a).
  • Administration of NPI-028 (0.75 g/kg) for four consecutive days in FH rats maintained on a continuous access schedule did not lead to any diminution of its alcohol-suppressant effects.
  • So lowering the levels of that brain chemical dopamine should help control an alcoholic’s cravings.

In retrospective studies, researchers select subjects with a specific disorder (e.g., alcoholism) and, using interviews, medical records, and other sources of information, try to determine the factors that contributed to the disease’s development. Conversely, the subjects of prospective studies are disease free at the study’s outset; accordingly, some subjects will develop the disorder under investigation, whereas others will not. This approach allows researchers to analyze the premorbid characteristics of both groups of subjects. Valerian (Valeriana officinalis) extract may lessen withdrawal symptoms and facilitate return to a normal sleep pattern following prolonged use of benzodiazepines such as clonazepam and lorazepam. The findings of animal studies show that Valerian in doses of 12mg per kilogram attenuates withdrawal symptoms in diazepam-dependent rats (Andreatini 1994).

Attenuation of alcohol consumption by a novel nontoxic ibogaine analogue(18-methoxycoronaridine) in alcohol-preferring rats

Alcohol withdrawal in humans produces well documented physical (somatic) symptoms, such as tremor, autonomic hyperactivity, nausea, vomiting, and seizures, but more importantly produces significant affective symptoms of anxiety, dysphoria, and depression-like symptoms. Depression scores decline during subsequent weeks of treatment but remain at close to 10 for Hamilton Depression Scores for up to 4 weeks of an inpatient treatment program (Brown and Schuckit 1988). In another study of inpatient alcoholics during withdrawal, the Beck Depression Inventory score was at 15 at withdrawal and remained at 12.8 two days into withdrawal and at 9.4 two weeks post-withdrawal (de Timary et al. 2008).

Prospective studies suggest, however, that the prospectively identified personality trait of willpower failed to predict outcome (Vaillant 1995). Several studies have indicated that sociopathy2 is a predisposing factor for alcoholism (e.g., Cloninger et al. 1988). The Core City study’s prospective design allowed researchers to determine whether sociopathy could lead to alcoholism (i.e., whether alcoholism was a symptom of the underlying behavioral disorder) or whether sociopathic symptoms were a consequence of alcoholism.

Break the new Barrier. The audience is at the solution

SDT describes the motivational, environmental (situational and contextual), and personality conditions that promote physical and mental well-being. SDT has received substantial support across behavioral domains, including behaviors that promote physical health (Gillison et al. 2019; Ng et al. 2012; Ntoumanis et al. 2020). SDT is uniquely positioned to further the understanding of harm reduction behaviors as it may describe not only why people engage in such behaviors, but also describes the process of behavior change, targets of intervention, and who may be more likely to respond to intervention. Yet, compared to other health domains, little research has investigated alcohol-related behaviors, and harm reduction behaviors in particular, from an SDT perspective. The evidence for the efficacy of harm reduction approaches to harmful alcohol use has accumulated over the past 30 years.

Negative reinforcement can be defined as the process by which removal of an aversive stimulus (e.g., negative emotional state of drug withdrawal) increases the probability of a response (e.g., dependence-induced drug intake to relieve the negative emotional state). Note that negative reinforcement is not punishment, although both involve an aversive stimulus. In punishment, the aversive stimulus suppresses behavior, including drug taking (e.g., disulfiram [Antabuse]). Negative reinforcement can be perhaps described in lay terms as reward via relief (i.e., relief reward), such as removal of pain or in the case of alcoholism removal of the negative emotional state of acute withdrawal or protracted abstinence. The three stages are conceptualized as interacting with each other, becoming more intense, and ultimately leading to the pathological state known as addiction (Koob and Le Moal 1997) (Fig. 1).

Potential use of medicinal plants in the treatment of alcoholism

In other words, the utility of a harm reduction approach to alcohol use (e.g., Marlatt and Witkiewitz 2002) is now widely accepted and warrants the need for theoretical models that focus directly on explaining harm reduction behaviors. Thus, the aim of the current paper is to encourage and improve research applying SDT to alcohol harm reduction behaviors by offering a research agenda with specific examples of how SDT can further harm reduction research. According to SDT, motivation is a multi-dimensional construct in that there are distinct types of motivation that vary in the extent to which they are self-determined, or autonomous (Ryan and Deci 2017). More specifically, these types of motivation exist on a continuum of self-determination (Figure 1). Motivation that is more self-determined is proposed to result in positive behavioral outcomes, such as increased energy and persistence in behavior (Ryan and Deci 2017). The shift in motivation from less to more self-determined motivation, referred to as internalization and integration (see Table 1), is posited to be a mechanism underlying behavior change.

Herbal Approaches to Alcohol Dependence

Importantly, the average effect of treatment on alcohol use was similar for both smokers and non-smokers, indicating that varenicline may be an effective pharmacotherapy for individuals who do and do not smoke. Natural supplements used to treat alcohol and drug abuse, reduce craving, decrease withdrawal symptoms or reduce the risk of relapse include vitamins, magnesium and zinc, Chinese and Ayurvedic herbal formulas, amino acids and essential fatty acids. Taking certain amino acids including taurine, and L-tryptophan may reduce alcohol craving or consumption and diminish withdrawal symptoms. One study found that taurine in doses up to 3gm/day significantly decreased alcohol withdrawal symptoms in hospitalized alcoholics undergoing acute detoxification. While most natural supplements have few or mild adverse effects when a quality brand is used at recommended dosages some may have serious adverse effects when taken at inappropriate high dosages or in combination with prescription medications.

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