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‘Cure’ for Alcoholism Has Its Fans, Detractors

Posted in Alcoholism Treatment

Chronic alcoholics often lament that if there were a medical cure to help them stop drinking, they’d take it.

A Boston-area biotechnology company claims it has just such a drug and, in fact, has been marketing it for nearly three years. But detractors say traditional means of abstinence — including counseling and therapy — remain the most effective and reliable means of providing relief from alcoholism.

Alkermes Inc. makes Vivitrol, a prescription drug that is injected once a month in the muscle of the buttocks. Vivitrol is the brand name for naltrexone, which is also known as naltrexone.

Testimonials abound for the effectiveness of Vivitrol, but the firm recently told the Boston Globe that it expects to generate no more than $24 million in sales for this fiscal year.

Among its drawbacks is the cost: About $800 a month, or $9,600 a year. But there are other issues challenging the success of Vivitrol. Many alcohol treatment programs are resistant to the use of drugs, and some doctors say Vivitrol won’t work for most of their patients.

Vivitrol acts on the brain’s receptors for pleasure, blocking the receptor’s ability to gain any reaction from chemicals such as alcohol. This is intended to reduce an alcoholic’s craving for alcohol by slowly releasing the drug over the course of a month.

As a rule, most alcohol treatment centers have relied on counseling and therapy rather than medication. Many addiction treatment centers prefer their clients be free of drugs, suggesting 12-step programs such as Alcoholics Anonymous provide a much more effective solution than prescription drugs.

Jim Frates, Alkermes’ chief financial officer, said his company recommends Vivitrol as a supplement to counseling, not as a replacement. And his company has its supporters.

Dr. Punyamurtula Kishore, medical director of Preventive Medicine Associates Inc. in Massachusetts, told the Boston Globe that Vivitrol has been used very successfully in his three-dozen clinics. He said he has prescribed it for hundreds of patients.

Other doctors said they have misgivings about Vivitrol studies. Dr. David Sack, chief executive of the Promises Treatment Centers in Malibu, Calif., said the drug works only for a small percentage of alcoholics. He prescribes it for patients who have intense cravings for alcohol even after weeks of therapy.

And Dr. Kim Dennis, medical director at the Timberline Knolls treatment center near Chicago, said the same mechanism that helps diminish the need for alcohol also dulls the natural highs of exercise, sex, or other activities.