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Researchers Tackling the Science of Sobriety

(March 31, 2007) -- Willpower. Counseling. Twelve steps.

For decades, these have been the front-line treatments for alcoholics.

But now, more than 70 years after a New York stockbroker and an Ohio surgeon founded Alcoholics Anonymous, researchers are looking to add pills to the treatment options.

In what could be a major shift in treating alcoholism, researchers are studying chemical pathways, genetics and stress factors to find drugs that make it easier for problem drinkers to resist alcohol.

It's potentially a huge market: There are nearly 8 million alcoholics in the United States, and about 1.5 million of them seek treatment each year.

The estimated cost of alcoholism to society is vast: billions of dollars a year in missed workdays, alcohol-related crime and traffic accidents.

"Alcoholism is a big, big disease, and it's a productivity killer," said Les Funtleyder, an analyst with Miller Tabak & Co., an institutional trading firm in New York. "Whatever company comes up with a solution that works is going to help public health and make a lot of money. I think it . . . safe to say it could be a blockbuster, depending on how well it works and what the side effects are."

The federal National Institute of Alcohol Abuse and Alcoholism is sponsoring nearly 100 clinical trials of drugs to treat alcoholism, compared with a handful a decade ago.

Most major drugmakers are pursuing alcohol treatments:

• Eli Lilly and Co. is working on at least four compounds that focus on different mechanisms and behaviors.

  • AstraZeneca is studying whether its antipsychotic drug Seroquel, taken with mood stabilizers, can help alcoholics who also have bipolar disorder.

  • Merck is comparing several drugs with the goal of preventing alcoholic relapse.

  • Forest Laboratories is studying whether Campral, an approved drug for alcoholics, can also be used early in alcohol detoxification rather than just in rehabilitation.

The work is complicated, and it could be years before a breakthrough, said Dr. William Chin, vice president of discovery research and clinical investigation at Lilly Research Laboratories.

"We're talking about the brain, a very complex organ which we're trying very hard to understand better," Chin said. "It's fair to say there's a lot we still don't understand."

Scientists say there's no silver bullet - a pill that will magically work on everyone, or even more wildly, that would allow alcoholics to continue to drink with no ill effects.

"People's genetic makeups are too different: No one drug will work on everybody," said Dr. Abhin Singla, an internist in Joliet, Ill., who specializes in treating addiction.

Medical experts say alcoholism is more than a single condition. Excessive drinking is triggered by many kinds of genetic and environmental factors, such as brain chemistry, anxiety or social gatherings.

The traditional prescription for alcoholics - staying sober one day at a time, with the help of support groups and counseling - has a checkered track record. About 90 percent of alcoholics relapse at least once within four years of treatment, the National Institute on Alcohol Abuse and Alcoholism says.

Lilly researchers stress that if the drugs are successful, they would complement, not replace, traditional treatments, such as AA and counseling.

"I think there will be much more research and, down the road, many more types of treatments for alcoholism," said Dr. Alexander Niculescu III, an assistant professor of psychiatry, medical neurobiology and neuroscience at Indiana University School of Medicine. "This is a huge market that has hardly been tapped."

By: John Russell
Source: Indianapolis Star

Last updated: 03/07

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