It is interesting to note that Tambour and Quertemont studied the effects of the same two drugs plus Disulfiram, an alcohol-deterrent drug. Their findings, in reviewing other studies, indicated slightly different results from Richardson. Since different drugs target different neuro-inhibitors, the drugs were used both separately and together. Quertemont discovered, in reviewing the results of previous and current studies, that none of the drugs worked particularly well, and that the combination of two of the drugs didn't seem to help. Her review of these studies contradicted the Richardson trial in which acamprosate was found to be ineffective.
Quertemont and Tambour ultimately concluded that the future of curing alcoholism lie in both discovery of new drugs and the refinement of the use of current drugs either singly or in combination.
In Willenbring and Gitlow's debate over the value of drugs to treat alcohol dependence, Dr. Gitlow concludes that until it is proven that the drugs provide a better outcome than the standard therapeutical treatments of today, we cannot be certain whether the drugs are helpful or harmful. They should, thus, be considered experimental.
While Dr. Willenbring concedes that much of the methodology for research trials has been flawed, he points out that a chain of studies that result in the same conclusion might be cause for some belief that a conclusion that the medications work might be in order. He further states that most of the medications have been proven effective in reducing dependence on alcohol.
Kranzler, in his discussion of efficacy of the drugs and getting them to market, indicates that he believes the primary drugs have proven to be effective. But, he says, their efficacy when compared to anti-depressants in limiting the symptoms of depression, is minimal. However, he feels that they are effective enough that, given the enormous scope of the problem of alcoholism, the drugs should be made more available.
III. Conclusion
Disulfiram was discovered, by accident, back in...
It has proven its effectiveness, evidently, in deterring alcoholics from drinking, and is known far and wide by doctors and alcoholics as a drug to treat this disease. Naltrexone, the newest of the drugs, has been prescribed over 200,000 times. Given our 18 million alcoholics however, this seems a pittance as far as putting a dent in alcoholism if, indeed, the drugs work. One has to ask also, why the different results from trials for drugs that have been prescribed since the end of WWII?
It seems to me that further research is always important, but we have drugs that evidently work. If we can develop more effective drugs to combat this deadly disease, then we should.
But let's use the ones we have, and, as Kranzler says, get the physicians to prescribe them.
Importance to Nursing
Women are alcoholics too, and their disease can affect their babies, as is well-known. It is important that nurses be aware of the medications available and ongoing research so that they can inform their patients and save babies who might otherwise be victims themselves.
Bibliography
Gitlow, S., & Willenbring, M. (2008). Are medications that reduce risk of drinking, or heavy drinking, or that promote abstinence, of value in the treatment of alcohol dependence? American Journal on Addictions (peer-reviewed), 17(1), 1-5, doi:10.1080/10550490701756047.
Kranzler, H. (2006). Medications to treat heavy drinking. Are we there yet? Addiction (peer-reviewed), 101(2), 153-154, doi:10.1111/j.1360-0443.2006.01324.x.
Richardson, K., Reid, S., Baillie, A., Morley, K., Teesson, M., Sannibale, C., et al. (2008). Do acamprosate or naltrexone have an effect on daily drinking by reducing craving for alcohol? Addiction, (peer-reviewed), 103(6), 953-959, doi:10.1111/j.1360-0443.2008.02215.x.
Tambour, S., & Quertemont, E. (2007). Preclinical and clinical pharmacology of alcohol dependence. Fundamental & Clinical Pharmacology (peer reviewed), 21(1), 9-28, doi:10.1111/j.1472-8206.2006.00459.x.
