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Acamprosate Underused in Alcoholism Treatment

Posted in Alcoholism Treatment

Acamprosate Underused in Alcoholism TreatmentAcamprosate is a medication that helps people affected by alcohol use disorder (alcohol abuse and/or alcoholism) to recover some of their normal brain function. It is one of the three medications in the U.S. specifically approved for alcohol-related treatment. In a study published in May 2014 in the Journal of Studies on Alcohol and Drugs, researchers from two U.S. universities sought to determine how many alcohol treatment programs across America include acamprosate-based treatment among their options. These researchers also looked at the frequency of acamprosate use in programs that give doctors the leeway to prescribe the medication.

Alcohol Use Disorder

People impacted by alcohol use disorder have at least two symptoms that indicate the presence of serious problems with non-addicted alcohol abuse and/or the presence of serious problems with alcohol dependence, also known as alcohol addiction or alcoholism. Since symptoms from both abuse and addiction can appear at the same time, the disorder’s criteria do not treat these symptoms as separate issues. Instead, doctors treat abuse and addiction as overlapping and equally serious concerns and count the number of combined symptoms in their patients. Minimally affected individuals have two or three of 11 potential symptoms and qualify as “mild” cases. People with four or five symptoms qualify as “moderate” cases, while people with six or more symptoms qualify as “severe” cases. In addition to acamprosate, two medications have received FDA approval for use in individuals diagnosed with alcohol abuse/alcoholism: disulfiram (Antabuse) and naltrexone (Vivitrol, ReVia). Topiramate (Topomax) is a fourth medication option not specifically approved for alcohol-related treatment by the FDA.

Acamprosate

Acamprosate is the generic name for a medication sold in the U.S. under the brand name Campral. This medication alters the levels of two key chemicals in the brain that essentially function as on/off switches for activity inside the brain’s nerve cells. People affected by physical alcohol dependence can experience long-term changes in these chemicals that contribute to alcohol-related withdrawal symptoms, including a general feeling of unease or unhappiness, sleeplessness and unusually high levels of anxiousness. Acamprosate does not eliminate the effects of alcohol withdrawal, but it can facilitate brain changes that make it easier to get through withdrawal without returning to alcohol consumption. As a rule, doctors only prescribe the medication to individuals who have stopped drinking and are also receiving some sort of non-medication-based treatment (i.e., psychotherapy or counseling) for their condition.

How Often Is the Medication Used?

In the study published in the Journal of Studies on Alcohol and Drugs, researchers from the University of Kentucky and the University of Georgia used a nationwide survey of organizations that treat alcohol use disorder to determine the extent of the role that acamprosate plays in the alcohol treatment process. Altogether, 307 organizations submitted information for the study. In addition to looking at how many of these organizations include acamprosate in their treatment programs, the researchers examined the factors that increase or decrease the likelihood that the medication will be used in any specific organization.

The researchers found that just 18 percent of the polled organizations include acamprosate among their treatment options. Factors that increase the odds that an organization will permit use of the medication include having a treatment program staff that includes licensed medical doctors, having contact with other organizations that also include acamprosate on their list of available treatments and gaining familiarity with acamprosate through interactions with drug company representatives. The researchers concluded that, among the organizations that give doctors the leeway to prescribe acamprosate, only roughly 6 percent of clients/patients diagnosed with alcohol use disorder receive the medication. Cited reasons for this low rate of use include relatively limited training on the proper prescribing of acamprosate, difficulty identifying the clients/patients most likely to benefit from the medication, problems getting clients/patients to take the medication consistently and concerns over the cost of acamprosate.

The study’s authors believe that the lack of widespread acamprosate availability and use probably has a significant negative impact on the medication’s usefulness as an alcohol use disorder treatment in the U.S. However, they also believe that availability and use of the medication can potentially improve if research is done on the most effective ways to get clients/patients, doctors and substance treatment organizations to learn more about acamprosate and how to use the medication effectively.