RE 154: Can Pills Help Control Our Drinking?

2018-01-29

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“Does anybody have experience with naltrexone, Antabuse (disulfiram), or Campral (acamprosate)?”

These drugs are designed to help people deal with the physical side effects of quitting alcohol. While readily available, most 12 step programs will not mention quit aids such as these. In the Radio Lab episode “The Fix”, they mention that a very small percentage of people in the early stages of drinking ever qualify for receiving drugs to help them quit. Many people will seek out an easy way to quit, and though these drugs may seem attractive, the only way to successfully move forward is by putting in the work.

Disulfiram - more commonly known as Antabuse, is intended to create negative side effects to break the positive association with drinking. It will not help with the physical cravings of quitting. The United States National Institutes of Health says “...it is unlikely that disulfiram will have any real effect on the drinking pattern of the chronic alcoholic.”

Naltrexone – blocks brain opioid receptors. Probably the most popular. It alters the brain's neurochemistry to make alcohol less rewarding. The alcohol molecule is similar to an opioid molecule and is received similarly in the brain. Naltrexone blocks the high one gets from drinking.

Acamprosate - more commonly known as Campral, is newer than the other drugs in the US. The complete workings of this drugs are currently unknown, but it appears to disrupt the activity of the gaba and glutamate neurotransmitter systems in the brain, essentially quickening the pace at which a brain affected by alcohol returns to normalcy.

Are these drugs a cure for alcoholism? The common experience is no. These pills only address the physical component of the disease, leaving the emotional and spiritual causes unchecked.

Some key points from “The Fix” episode by Radio Lab:

1 – Billy's Story – The drugs did what they were supposed to do, in that they helped him get his drinking under control, but they did not cure the underlying causes for his alcoholism.

2 – The separation between the addiction community and the medical community started in the 30s during the tuberculosis epidemic, eventually leading to the medical community relying on medicine and the recovery community relying on a higher power.

3 – According to Anna Rose-Childress, people prone to addiction are the fittest of the fit, evolutionary speaking. They are rewarded from their environment in more subtle ways, which seems to backfire in today's modern environment.

Stephen, with 12 days since his last drink, shares his story.

SHOW NOTES

[13:33] Paul Introduces Stephen. How long have you been sober? Who are you? What do you do for fun?

Over 12 days. From Brisbane, Queensland, Australia. 29yo. Works as a graphic and web designer. Recent graduate of Nutritional Medicine. Engaged to be married. Love fitness and reading self-help books.

[15:00] When did you realize that you weren't drinking normally?

Realized he couldn't just have a quiet night. One drink lead to many, which lead to a three day bender, which lead to difficulty stopping drinking.

[16:00] How did your drinking progress?

Tried staying drunk to avoid hangovers.

[18:00] Did you experience a kind of rock bottom?

Not a rock bottom, but a realization that he had no self control as long as there was alcohol in his system.

[18:55] Did you put any rules in place to moderate your drinking?

Tried general strategies. Only drinking at night, etc. They went out the window quite often. Tried using Antabuse but couldn't afford it.

[20:19] What was it like using Antabuse?

Was moderate successful. Quit for 3 months. Doesn't cure the holistic problem.

[22:50] Are you still using medication to help you stay sober?

No. Not working for him in the long run.

[25:00] How did you pick your sobriety date? What strategies are you using?

Figured it was a good year to step it up. Trying to keep busy. Noticed that I have an addictive personality. Figured I'd meditate more and focus on my career.

[28:11] What have you lost to alcohol?

Lost a lot of friends. Made poor choices while drinking. Lost a previous romantic relationship. Lead to positive outcomes.

[30:20] What advice would you give to your younger self in regards to drinking?

“You don't need to go out and hit up the nightclubs to have fun.” I used to drink and play video games. The association is still strong and tough to break.

[31:45] Have you tried AA?

He considered it. This year he may try it out to experience the community.

[34:20] Do you experience cravings? If so, what do you when they arise?

Tried waiting it out. Reaches out to someone at church. Avoids the internal conflict.

[36:30] Rapid Fire Round

What was your worst memory from drinking?

Out at a pub, decided to go outside and sit on a bench. Woke up in an ambulance. Needed stitches from passing out and hitting his head.

Did you ever have an “oh-shit” moment?

Was on a 3 day bender. Went for a drive and because of sleep deprivation was in a car accident.

What’s your plan moving forward?

One day at a time. Keep setting positive goals. Stay fit. Looking up.

What’s your favorite resource in recovery?